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General NPI Number Information
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NPI Number | 1285751362
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Entity Type | Organization
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Legal Business Name | ANTHONY J. PALAZZO, M.D.,APMC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 405 AVENUE F
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City | BOGALUSA
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State | LA
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Zip | 70427-3633
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Country | US
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Telephone | 985-732-1568
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Fax | 985-732-4458
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | BOGALUSA
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State | LA
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Zip | 70429-0370
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Country | US
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Telephone | 985-732-1568
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Fax | 985-732-4458
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY JUDE PALAZZO
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Credential | MD
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Telephone | 985-732-1568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD.07154R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APO4688
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License Number State | LA
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