Provider Demographics
NPI:1497775282
Name:ZIBARI, GAZI B (MD)
Entity Type:Individual
Prefix:
First Name:GAZI
Middle Name:B
Last Name:ZIBARI
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 1:2751 ALBERT BICKNELL DR
Mailing Address - Street 2:STE 4A
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103
Mailing Address - Country:US
Mailing Address - Phone:318-212-4275
Mailing Address - Fax:318-242-8511
Practice Address - Street 1:2751 ALBERT BICKNELL DR
Practice Address - Street 2:STE 4A
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103
Practice Address - Country:US
Practice Address - Phone:318-212-4275
Practice Address - Fax:318-242-8511
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07137R204F00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1972207Medicaid
LA1972207Medicaid
LA5R871F610Medicare ID - Type Unspecified