MEDICARE: DR. ANN C ZEDLITZ 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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	023278	LA
2	207N00000X	Dermatology Physician	23278	LA

General Provider Information

NPI Number	:	1902976921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN C ZEDLITZ M.D.

Provider Business Mailing Address
First Line	:	5326 ODONOVAN DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4691
Country	:	US
Telephone Number	:	225-769-7546
Fax Number	:	225-769-0471

Provider Business Practice Location Address
First Line	:	5326 ODONOVAN DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4691
Country	:	US
Telephone Number	:	225-769-7546
Fax Number	:	225-769-0471

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	12/27/2010

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