Individual
DR. JONATHAN I LAZZARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4449 STATE ROUTE 159, CHILLICOTH, OH 45601-8620
(740) 775-1260
(740) 773-1264
Mailing address
200 MEDICAL CENTER DR, MIDDLETOWN, OH 45005-5200
(513) 974-5252
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101278859
VA
2084P0800X
Psychiatry Physician
Primary
34.011075
OH
208D00000X
General Practice Physician
34.011075
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116608
—
OH
Enumeration date
05/25/2012
Last updated
10/02/2024
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