Provider Demographics
NPI:1659465698
Name:WITZIG, RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:WITZIG
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 1:4315 HOUMA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2940
Mailing Address - Country:US
Mailing Address - Phone:504-455-4622
Mailing Address - Fax:504-455-4688
Practice Address - Street 1:4315 HOUMA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2940
Practice Address - Country:US
Practice Address - Phone:504-455-4622
Practice Address - Fax:504-455-4688
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08457R207RI0200X
LAMD.08457R208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1937649Medicaid
LAF37336Medicare UPIN
LA5R221Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER