MEDICARE: DR. JOSEPH MARRAZZO III M.D.

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	208C00000X	Colon & Rectal Surgery Physician	15295	LA

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

General Provider Information

NPI Number	:	1568455855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MARRAZZO III M.D.

Provider Business Mailing Address
First Line	:	211 4TH ST
Second Line	:	BOX 30160
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8421
Country	:	US
Telephone Number	:	318-487-8181
Fax Number	:	318-487-0595

Provider Business Practice Location Address
First Line	:	501 MEDICAL CENTER DR
Second Line	:	SUITE 410
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8124
Country	:	US
Telephone Number	:	318-487-8181
Fax Number	:	318-487-0595

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	07/08/2007

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