Individual
DR. KELLY NELSON MIZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4648 S I 10 SERVICE RD W, METAIRIE, LA 70001-1225
(504) 883-4800
Mailing address
4648 S I 10 SERVICE RD W, METAIRIE, LA 70001-1225
(504) 883-4800
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
204321
LA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
N8224
TX
Other
Enumeration date
10/19/2006
Last updated
06/25/2011
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