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General NPI Number Information
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NPI Number | 1013196245
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Entity Type | Organization
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Legal Business Name | PAGES FAMILY PRACTICE LTD
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 1157 N MONROE DR SUITE 210
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City | XENIA
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State | OH
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Zip | 45385-1697
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Country | US
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Telephone | 937-352-2750
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Fax | 937-352-3751
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Provider Business Mailing Address
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Address Line | 1157 N MONROE DR SUITE 210
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City | XENIA
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State | OH
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Zip | 45385-1697
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Country | US
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Telephone | 937-352-2750
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Fax | 937-352-3751
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LAZARO J PAGES
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Credential | MD
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Telephone | 937-352-2750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35068066P
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License Number State | OH
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