Provider Demographics
NPI:1063663052
Name:METZINGER PLASTIC SURGERY
Entity Type:Organization
Organization Name:METZINGER PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:METZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:504-459-3517
Mailing Address - Street 1:3601 HOUMA BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4326
Mailing Address - Country:US
Mailing Address - Phone:504-459-3517
Mailing Address - Fax:504-885-1360
Practice Address - Street 1:3601 HOUMA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4326
Practice Address - Country:US
Practice Address - Phone:504-459-3517
Practice Address - Fax:504-885-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019581174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAC70879Medicare UPIN
5J572Medicare PIN