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General NPI Number Information
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NPI Number | 1710004023
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Entity Type | Organization
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Legal Business Name | L LAZARO IV APMC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 913 S COLLEGE RD 110
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City | LAFAYETTE
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State | LA
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Zip | 70503-3060
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Country | US
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Telephone | 337-237-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 913 S COLLEGE RD 110
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City | LAFAYETTE
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State | LA
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Zip | 70503-3060
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Country | US
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Telephone | 337-237-5008
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | L LAZARO
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Credential | MD
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Telephone | 337-237-5008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 020490
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License Number State | LA
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