Healthcare Provider Details

I. General information

NPI: 1215227590
Provider Name (Legal Business Name): JOZEF LAZAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 TOWN CENTRE DR SUITE 200
EAGAN MN
55123-1033
US

IV. Provider business mailing address

60 PLATO BLVD E SUITE 270
SAINT PAUL MN
55107-1827
US

V. Phone/Fax

Practice location:
  • Phone: 651-251-3300
  • Fax:
Mailing address:
  • Phone: 651-209-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number59737
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: