Individual
DR. EARLE F MAZYCK
Active
Individual
DR. EARLE F MAZYCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6961
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00063192A
GEORGIA MEDICAID NUMBER
GA
01
—
051512613
AL BLUE CROSS PROVIDER
AL
05
—
051552726
—
AL
01
—
4790691001
CIGNA PROVIDER NUMBER
AL
01
—
61659
FLORIDA BLUE CROSS NUMBER
FL
01
—
P00009152
RRMC PROVIDER NUMBER
AL
Enumeration date
10/31/2005
Last updated
12/08/2009
Update your record
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