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General NPI Number Information
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NPI Number | 1891761094
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Entity Type | Individual
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Provider Name | LAXMAN S IYER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 215 E 1ST ST, STE 214
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City | DIXON
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State | IL
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Zip | 61021
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Country | US
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Telephone | 815-285-5815
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Fax | 815-285-5816
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Provider Business Mailing Address
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Address Line | 215 E 1ST ST, STE 212
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City | DIXON
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State | IL
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Zip | 61021
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Country | US
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Telephone | 815-285-5815
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Fax | 815-285-5816
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 036-052760
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License Number State | IL
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