Organization
LYNETTE HAZELBAKER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETTE HAZELBAKER MD (PROVIDER)
(765) 864-8727
Entity
Organization
Contact information
Practice address
3508 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 864-8727
(765) 453-8638
Mailing address
3508 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 864-8727
(765) 453-8638
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100137490B
—
IN
Enumeration date
09/08/2010
Last updated
07/21/2022
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