Provider Demographics
NPI:1134341753
Name:NIX MD & BALTZ MD, APMC
Entity type:Organization
Organization Name:NIX MD & BALTZ MD, APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KLOTZBACH
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:504-738-2431
Mailing Address - Street 1:3439 PRYTANIA ST STE 502
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-897-8272
Mailing Address - Fax:504-897-7433
Practice Address - Street 1:3439 PRYTANIA ST STE 502
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-897-8272
Practice Address - Fax:504-897-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========0OtherBLUE CROSS BLUE SHIELD LA
LA5B937Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER #