Individual
DR. ANTHONY JUDE PALAZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 AVENUE F, BOGALUSA, LA 70427-3633
(985) 732-1568
(985) 732-4458
Mailing address
PO BOX 370, BOGALUSA, LA 70429-0370
(985) 732-1568
(985) 732-4458
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
MD.07154R
LA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD.07154R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018495
—
MS
05
—
1367061
—
LA
01
—
19669647423
HUMANA
LA
01
—
4402936
AETNA
LA
Enumeration date
06/18/2006
Last updated
12/21/2021
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