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General NPI Number Information
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NPI Number | 1780642694
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Entity Type | Organization
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Legal Business Name | SOUTHEAST IOWA CARDIOLOGY
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 1223 S GEAR AVE SUITE 201
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1682
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Country | US
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Telephone | 319-754-4004
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Fax | 319-753-5498
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Provider Business Mailing Address
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Address Line | 1223 S GEAR AVE SUITE 201
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1682
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Country | US
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Telephone | 319-754-4004
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Fax | 319-753-5498
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY V LAZAR
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Credential | M.D.
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Telephone | 319-754-4004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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