Healthcare Provider Details

I. General information

NPI: 1477502474
Provider Name (Legal Business Name): STEPHEN ERIC METZINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3223 8TH ST SUITE 200
METAIRIE LA
70002-1623
US

IV. Provider business mailing address

3223 8TH ST SUITE 200
METAIRIE LA
70002-1623
US

V. Phone/Fax

Practice location:
  • Phone: 504-309-7061
  • Fax: 504-309-4853
Mailing address:
  • Phone: 504-309-7061
  • Fax: 504-309-4853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number019581
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number019581
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number019581
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: