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General NPI Number Information
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NPI Number | 1174640569
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Entity Type | Individual
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Provider Name | GERALD HENRY MAZUREK M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 4300 W 7TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5446
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Country | US
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Telephone | 501-257-5839
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Fax |
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Provider Business Mailing Address
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Address Line | 4359 E KINGS POINT CIR
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City | DUNWOODY
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State | GA
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Zip | 30338-5916
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Country | US
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Telephone | 770-458-3924
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Fax |
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | H7186
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License Number State | TX
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