Healthcare Provider Details

I. General information

NPI: 1780926337
Provider Name (Legal Business Name): JOHN PETER LAZAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 03/24/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 WEST MAIN STREET
NEWARK OH
43055
US

IV. Provider business mailing address

1320 WEST MAIN STREET
NEWARK OH
43055
US

V. Phone/Fax

Practice location:
  • Phone: 220-564-4000
  • Fax: 220-564-4342
Mailing address:
  • Phone: 220-564-4000
  • Fax: 220-564-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35125365
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.125365
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35125365
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.125365
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: