Individual
JOSEPH V LAZZARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8633 N STATE ROAD 550, BRUCEVILLE, IN 47516-6096
(812) 324-2963
Mailing address
8633 N STATE ROAD 550, BRUCEVILLE, IN 47516-6096
(812) 324-2963
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
01027352A
IN
208000000X
Pediatrics Physician
01027352A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100154470A
—
IN
Enumeration date
03/10/2006
Last updated
12/26/2016
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