Provider Demographics
NPI:1083912828
Name:AZIZ, MOHAMMED SADAT (DO)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:SADAT
Last Name:AZIZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 JACKSON STREET EXTENSION, STE C-355
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2555
Mailing Address - Country:US
Mailing Address - Phone:318-621-7161
Mailing Address - Fax:318-319-0177
Practice Address - Street 1:4501 JACKSON STREET EXTENSION, STE C-355
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2555
Practice Address - Country:US
Practice Address - Phone:318-621-7161
Practice Address - Fax:318-319-0177
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA303703207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology