Individual
CALEB I MARTINEZ LAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(770) 719-7000
Mailing address
718 NIGHTWIND WAY, STOCKBRIDGE, GA 30281-9134
(678) 978-0169
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
11208
GA
367H00000X
Anesthesiologist Assistant
—
GA
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
06/15/2022
Last updated
10/18/2022
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