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General NPI Number Information
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NPI Number | 1235315524
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Entity Type | Organization
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Legal Business Name | JOHN B. CAZALE, M.D., A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 4720 S I 10 SERVICE RD W SUITE 301
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City | METAIRIE
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State | LA
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Zip | 70001-7404
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Country | US
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Telephone | 504-885-8225
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Fax | 504-885-7642
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Provider Business Mailing Address
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Address Line | 4720 S I 10 SERVICE RD W SUITE 301
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City | METAIRIE
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State | LA
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Zip | 70001-7404
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Country | US
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Telephone | 504-885-8225
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Fax | 504-885-7642
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN B CAZALE IV
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Credential | MD
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Telephone | 504-885-8225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 012260
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License Number State | LA
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