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General NPI Number Information
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NPI Number | 1508000381
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Entity Type | Individual
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Provider Name | JEFFERY RYAN GRIZZAFFI D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2009
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 901 WILSON ST STE C-2
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City | LAFAYETTE
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State | LA
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Zip | 70503-2439
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Country | US
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Telephone | 337-232-3576
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Fax | 337-233-2816
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Provider Business Mailing Address
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Address Line | 901 WILSON ST STE C-2
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City | LAFAYETTE
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State | LA
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Zip | 70503-2439
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Country | US
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Telephone | 337-232-3576
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Fax | 337-233-2816
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DPM200025
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License Number State | LA
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