Healthcare Provider Details

I. General information

NPI: 1679530687
Provider Name (Legal Business Name): LINDA F LAZAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N DUNLAP ST STE 400
MEMPHIS TN
38105-4625
US

IV. Provider business mailing address

51 N DUNLAP ST STE 400
MEMPHIS TN
38105-4625
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-7642
  • Fax: 901-448-8015
Mailing address:
  • Phone: 901-448-7642
  • Fax: 901-448-8015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number15692
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: