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NPI Code Detail

MEDICARE: DR. STEVEN A FERZOCO M.D.

MEDICARE:  DR. STEVEN A FERZOCO  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
1174400000XSpecialist00023957AL
22085R0202XDiagnostic Radiology PhysicianMD.23957AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15000055298OTHERALMEDICARE PROVIDER NUMBER

Other Identifiers

General Provider Information

NPI Number : 1952303208
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN A FERZOCO M.D.
Provider Business Mailing Address
First Line : PO BOX 678063
Second Line :
City : DALLAS
State : TX
Zip : 75267-8063
Country : US
Telephone Number : 662-620-7102
Fax Number : 662-620-7106
Provider Business Practice Location Address
First Line : 1111 S RALEIGH AVE
Second Line : STE 100A
City : SHEFFIELD
State : AL
Zip : 35660-6350
Country : US
Telephone Number : 662-620-7102
Fax Number : 662-620-7106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 02/07/2019

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Directions to “ DR. STEVEN A FERZOCO M.D.” Practice Location

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