Healthcare Provider Details

I. General information

NPI: 1578756722
Provider Name (Legal Business Name): JOHN FRANKLIN LAZAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW RM G-253
WASHINGTON DC
20010
US

IV. Provider business mailing address

110 IRVING ST NW RM G-253
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-8115
  • Fax: 202-877-3699
Mailing address:
  • Phone: 202-877-8115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD452597
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License NumberMD452597
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD452597
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: