Individual
MAXWELL LAZINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-3221
(573) 815-6343
Mailing address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-3221
(573) 815-6343
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2002007687
MO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2002007687
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205811201
—
MO
Enumeration date
10/04/2005
Last updated
11/14/2023
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