Provider Demographics
NPI:1598778912
Name:ANZ, BERTRAND MARQUESS II (MD)
Entity Type:Individual
Prefix:MR
First Name:BERTRAND
Middle Name:MARQUESS
Last Name:ANZ
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:122 N 20TH ST
Mailing Address - Street 2:BLDG 26
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801
Mailing Address - Country:US
Mailing Address - Phone:334-749-1486
Mailing Address - Fax:334-749-1748
Practice Address - Street 1:122 N 20TH ST
Practice Address - Street 2:BLDG 26
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801
Practice Address - Country:US
Practice Address - Phone:334-749-1486
Practice Address - Fax:334-749-1748
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2011-11-21
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Provider Licenses
StateLicense IDTaxonomies
AL8877207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051003701OtherBLUE CROSS OF ALABAMA
ALAN000003701Medicaid
AL051077652OtherBLUE CROSS OF ALABAMA
ALAN000077652Medicaid
630691977OtherCIGNA HEALTHCARE
0810168OtherUNITED HEALTHCARE
180029278OtherMEDICARE RAILROAD
630691977OtherCIGNA HEALTHCARE
0810168OtherUNITED HEALTHCARE
AL051003701OtherBLUE CROSS OF ALABAMA