Individual
JOE MARIE JOSE DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0001
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
206398
LA
207R00000X
Internal Medicine Physician
4301096030
MI
208M00000X
Hospitalist Physician
Primary
206398
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2351711
—
LA
Enumeration date
08/31/2010
Last updated
09/02/2021
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