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General NPI Number Information
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NPI Number | 1760474084
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Entity Type | Individual
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Provider Name | GEORGE NICK GUZZARDO JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 07/26/2013
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Provider Practice Location Address
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Address Line | 180 W ESPLANADE AVE EMERGENCY DEPARTMENT
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City | KENNER
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State | LA
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Zip | 70065-2467
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Country | US
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Telephone | 504-464-8015
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Fax | 504-464-8538
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Provider Business Mailing Address
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Address Line | 34 CHATEAU LATOUR DR
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City | KENNER
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State | LA
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Zip | 70065-2021
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Country | US
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Telephone | 504-469-1201
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Fax | 504-469-1201
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 13928
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13928
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License Number State | LA
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