MEDICARE: DR. ALBERT NICHOLAS RIZZO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	31420	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00010233	OTHER	AZ	RAILROAD MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AZ0747730	OTHER	AZ	BC/BS ID NUMBER

General Provider Information

NPI Number	:	1174521819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT NICHOLAS RIZZO MD

Provider Business Mailing Address
First Line	:	PO BOX 785
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86405-0785
Country	:	US
Telephone Number	:	928-854-6500
Fax Number	:	928-854-6206

Provider Business Practice Location Address
First Line	:	1972 MESQUITE AVE
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5729
Country	:	US
Telephone Number	:	928-854-6500
Fax Number	:	928-854-6206

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	05/16/2024

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