| Doctor Name: | DR. EZEKIEL J WETZEL |
| NPI Number: | 1215913611 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A90433 |
| Business Practice Address: | 1501 Kings Hwy Department Of Anesthesia Shreveport, LA - 711034228 |
| Business Phone Number: | 3186755298 |
| Business Fax Number: | 3186756681 |
| Mailing Address: | 9505 Rhapsody Ln, SHREVEPORT |
| State: | LA |
| Postal Code: | 711184245 |
| Phone Number: | 3186755298 |
| Fax Number: | 3186756681 |
| NPI Enumeration Date: | 12/16/2005 |
| NPI Last Update Date: | 08/07/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A90433 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |