Provider Demographics
NPI:1841363108
Name:RIZZO, MONTY JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:MONTY
Middle Name:JOSEPH
Last Name:RIZZO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ANDRE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2159
Mailing Address - Country:US
Mailing Address - Phone:337-365-3541
Mailing Address - Fax:337-365-0863
Practice Address - Street 1:1100 ANDRE ST
Practice Address - Street 2:STE 100
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2159
Practice Address - Country:US
Practice Address - Phone:337-365-3541
Practice Address - Fax:337-365-0863
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD012758207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1199567Medicaid
LA1199567Medicaid
B65501Medicare UPIN