Provider Demographics
NPI:1780802942
Name:W. ROSS CAZAYOUX, M.D., LLC
Entity type:Organization
Organization Name:W. ROSS CAZAYOUX, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:CAZAYOUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-893-2701
Mailing Address - Street 1:101 JUDGE TANNER BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7503
Mailing Address - Country:US
Mailing Address - Phone:985-893-2701
Mailing Address - Fax:985-893-4221
Practice Address - Street 1:101 JUDGE TANNER BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7503
Practice Address - Country:US
Practice Address - Phone:985-893-2701
Practice Address - Fax:985-893-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.201364208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSFC0185771OtherDEA