Provider Demographics
NPI:1518444546
Name:MCZEAL, ERIC T
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:T
Last Name:MCZEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 STEELE BLVD APT 11
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5175
Mailing Address - Country:US
Mailing Address - Phone:225-445-9713
Mailing Address - Fax:225-778-5068
Practice Address - Street 1:322 STEELE BLVD APT 11
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-445-9713
Practice Address - Fax:225-778-5068
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty