Individual
MATTHEW AARON HAZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
631 PROFESSIONAL DR STE 360, LAWRENCEVILLE, GA 30046-3370
(678) 312-2700
Mailing address
631 PROFESSIONAL DR STE 360, LAWRENCEVILLE, GA 30046-3370
(678) 312-2700
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
074233
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003161954A
—
GA
05
—
003161954B
—
GA
05
—
003161954C
—
GA
05
—
003161954D
—
GA
05
—
003161954E
—
GA
05
—
003161954F
—
GA
01
—
03225408
AMERIGROUP
GA
01
—
1143430
WELLCARE
GA
01
—
8284544
CIGNA
GA
Enumeration date
05/05/2009
Last updated
12/14/2020
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