Provider Demographics
NPI:1013064732
Name:GRIZZAFFI, JOSEPH ANTHONY JR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:GRIZZAFFI
Suffix:JR
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 1:5131 ODONOVAN DR
Mailing Address - Street 2:STE 300
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4782
Mailing Address - Country:US
Mailing Address - Phone:225-374-0400
Mailing Address - Fax:225-374-0430
Practice Address - Street 1:5131 ODONOVAN DR
Practice Address - Street 2:STE 300
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4782
Practice Address - Country:US
Practice Address - Phone:225-374-0400
Practice Address - Fax:225-374-0430
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0198862084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1993051Medicaid