Provider Demographics
NPI:1477502474
Name:METZINGER, STEPHEN ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ERIC
Last Name:METZINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 8TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1623
Mailing Address - Country:US
Mailing Address - Phone:504-309-7061
Mailing Address - Fax:504-309-4853
Practice Address - Street 1:3223 8TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1623
Practice Address - Country:US
Practice Address - Phone:504-309-7061
Practice Address - Fax:504-309-4853
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0195812086S0122X, 207YX0007X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
5J572Medicare ID - Type Unspecified
LAC70879Medicare UPIN