Provider Demographics
NPI:1386812212
Name:LOUIS G IZZO DPM LLC
Entity type:Organization
Organization Name:LOUIS G IZZO DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PODIATRIC MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:IZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-523-6700
Mailing Address - Street 1:255 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3422
Mailing Address - Country:US
Mailing Address - Phone:724-523-6700
Mailing Address - Fax:724-523-2296
Practice Address - Street 1:255 S 8TH ST
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3422
Practice Address - Country:US
Practice Address - Phone:724-523-6700
Practice Address - Fax:724-523-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005609213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000145374OtherUNISON
PA228532OtherCOVENTRY HEALTHCARE
PA0019578490001Medicaid
PA6457419OtherCIGNA
PA7538456OtherAETNA
PA321679OtherUPMC
PAP00463385OtherRAILROAD MEDICARE
PA2015661OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA=========OtherUNITED MINE WORKERS
PA228532OtherCOVENTRY HEALTHCARE
PA7538456OtherAETNA
PAP00463385OtherRAILROAD MEDICARE