Individual
DR. LAVERN R DAVIDHIZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
206 W ROCKWELL AVE, SUITE 100, SOLDOTNA, AK 99669-7411
(907) 262-7566
(907) 262-0809
Mailing address
206 W ROCKWELL AVE, SUITE 100, SOLDOTNA, AK 99669
(907) 262-7566
(907) 262-0809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1454
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000WCHHM
MEDICARE GROUP NUMBER
AK
05
—
MD1454
—
AK
Enumeration date
08/15/2006
Last updated
10/16/2012
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