Individual
DR. NICHOLAS G LEZAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 THORNBURY PL, O FALLON, IL 62269-6811
(618) 229-5220
Mailing address
901 THORNBURY PL, O FALLON, IL 62269-6811
(618) 229-5220
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
77082
MA
Other
Enumeration date
11/10/2005
Last updated
03/20/2009
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