Provider Demographics
NPI:1184893463
Name:KITZMAN, GEOFFREY ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:ALLEN
Last Name:KITZMAN
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 1:5620 READ BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3106
Mailing Address - Country:US
Mailing Address - Phone:504-592-6437
Mailing Address - Fax:504-592-6438
Practice Address - Street 1:5620 READ BLVD STE 600
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3106
Practice Address - Country:US
Practice Address - Phone:504-592-6437
Practice Address - Fax:504-592-6438
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.202734207RG0100X
MS22824208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1079791Medicaid
MS01822863Medicaid
LA1079791Medicaid
LA4P0107061Medicare PIN