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Individual

DR. JOHN MARTIN LASAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
04-29030
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040016259
RAILROAD MEDICARE
KS
05
100396360A
KS
01
100888
BLUE CROSS
KS
01
412510
FIRSTGAURD
KS
01
48118525067206A003
CHAMPUS
KS
01
9633
PHS-PPK
KS
Enumeration date
06/01/2005
Last updated
11/23/2022
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