Provider Demographics
NPI:1508000381
Name:GRIZZAFFI, JEFFERY RYAN (DPM)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:RYAN
Last Name:GRIZZAFFI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WILSON ST STE C-2
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2439
Mailing Address - Country:US
Mailing Address - Phone:337-232-3576
Mailing Address - Fax:337-233-2816
Practice Address - Street 1:901 WILSON ST STE C-2
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2439
Practice Address - Country:US
Practice Address - Phone:337-232-3576
Practice Address - Fax:337-233-2816
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPM200025213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery