Individual
DR. WILLIAM DOUGLAS LAZENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
220 W COLLEGE ST STE B, GRIFFIN, GA 30224-4250
(770) 233-1080
(770) 233-3680
Mailing address
220 W COLLEGE ST STE B, GRIFFIN, GA 30224-4250
(770) 233-1080
(770) 233-3680
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
051969
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I025868
MEDICARE PTAN
GA
Enumeration date
05/26/2006
Last updated
06/22/2010
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