MEDICARE: ZACHARY ORTHOPAEDIC CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2964486970	OTHER	LA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992773949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZACHARY ORTHOPAEDIC CARE CENTER

Provider Business Mailing Address
First Line	:	PO BOX 975
Second Line	:	ZACHARY ORTOPAEDIC CARE CENTER
City	:	ZACHARY
State	:	LA
Zip	:	70791
Country	:	US
Telephone Number	:	225-658-9996
Fax Number	:	225-658-9970

Provider Business Practice Location Address
First Line	:	4845 MAIN ST
Second Line	:	SUITE B-1
City	:	ZACHARY
State	:	LA
Zip	:	70791-3943
Country	:	US
Telephone Number	:	225-658-9996
Fax Number	:	225-658-9970

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRIAN E KOZAR
Credential	:	MD
Telephone Number	:	225-658-9996

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	05/13/2013

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