Individual
MR. GUSTAVO DANIEL LUZARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, UMMC NEUROSURGERY 7TH FLOOR, JACKSON, MS 39216-4500
(601) 984-5700
Mailing address
2500 N STATE ST, UMMC NEUROSURGERY 7TH FLOOR, JACKSON, MS 39216-4500
(601) 984-5700
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
19202
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08482322
—
MS
01
—
P00675236
RAILROAD MEDICARE
MS
Enumeration date
06/07/2007
Last updated
06/18/2012
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