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
1	174400000X	Specialist	00023957	AL
2	2085R0202X	Diagnostic Radiology Physician	MD.23957	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
15	000055298	OTHER	AL	MEDICARE PROVIDER 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	51524639	OTHER	AL	BC OBGYN
3	51531407	OTHER	AL	BC HALEYVILLE
4	51531408	OTHER	AL	BC RUSSELLVILLE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	C300	OTHER	AL	MC GROUP
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	51507878	OTHER	AL	BC ECM
13	51543277	OTHER	AL	BC EAST
14	51543312	OTHER	AL	BC SHOALS

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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