Mr Louis Lee Mizell Jr Jr, MD is a medicare enrolled "Specialist" physician in Draper, Utah. His current practice location is
74 E Kimballs Ln Ste 330, Draper, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 545-8363.
Mr Louis Lee Mizell Jr Jr is licensed to practice in Utah (license number 82-168364-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851396964.
Physician's Profile
Full Name | Mr Louis Lee Mizell Jr Jr |
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Gender | Male |
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Speciality | Specialist |
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Location | 74 E Kimballs Ln Ste 330, Draper, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1851396964
- Provider Enumeration Date: 06/15/2005
- Last Update Date: 03/21/2019
Medicare PECOS Information:
- PECOS PAC ID: 3375889728
- Enrollment ID: I20211122002821
Medical Identifiers
Medical identifiers for Mr Louis Lee Mizell Jr Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851396964 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080P0206X | Pediatrics - Pediatric Gastroenterology | 168364-1205 (Utah) | Secondary |
174400000X | Specialist | 82-168364-1205 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Louis Lee Mizell Jr Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Louis Lee Mizell Jr Jr, MD 5770 So 250 E, Suite 330, Murray, UT 84107 Ph: (801) 314-4455 | Mr Louis Lee Mizell Jr Jr, MD 74 E Kimballs Ln Ste 330, Draper, UT 84020-5006 Ph: (801) 545-8363 |
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