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General NPI Number Information
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NPI Number | 1003848151
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Entity Type | Individual
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Provider Name | JOHN EDWARD ZITZMANN III R.PH.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 503 MCMILLAN RD
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City | WEST MONROE
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State | LA
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Zip | 71291-5327
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Country | US
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Telephone | 318-329-4643
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Fax | 318-329-4647
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Provider Business Mailing Address
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Address Line | 202 COMANCHE TRL
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City | WEST MONROE
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State | LA
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Zip | 71291-8108
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Country | US
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Telephone | 318-396-3679
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Fax | 318-329-4647
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9992
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License Number State | LA
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