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Individual

LISA M HAZELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
115 8TH ST NE, CEDAR RAPIDS, IA 52401-1013
(319) 363-3565
(319) 363-4001
Mailing address
115 8TH ST NE, CEDAR RAPIDS, IA 52401-1013
(319) 363-3565
(319) 363-4001

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28669
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0085274
IA
01
08454
BCBS
IA
Enumeration date
08/21/2006
Last updated
07/08/2007
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