Individual
DR. BRENT MAZOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3223 8TH ST, METAIRIE, LA 70002-1623
(504) 833-7770
(504) 833-7782
Mailing address
3223 8TH ST, METAIRIE, LA 70002-1623
(504) 833-7770
(504) 833-7782
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
004536
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1914401
—
LA
Enumeration date
09/05/2006
Last updated
07/10/2009
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