Provider Demographics
NPI:1164422036
Name:FAZIO, FRANK L (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:L
Last Name:FAZIO
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
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Mailing Address - Street 1:604 N ACADIA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4897
Mailing Address - Country:US
Mailing Address - Phone:985-446-5079
Mailing Address - Fax:985-447-2497
Practice Address - Street 1:8080 BLUEBONNET BLVD STE 2222
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7828
Practice Address - Country:US
Practice Address - Phone:225-769-2222
Practice Address - Fax:225-766-2068
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA013781207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA690168OtherAETNA
LA06008OtherBLUE CROSS
LA1312100Medicaid
LA690168OtherAETNA