Individual
JESUS L. LIZARZABURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 GRAFTON DR, YORKTOWN, VA 23692-2152
(757) 898-7737
(757) 898-8377
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101102625
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080007665
RR MEDICARE
VA
01
—
318662
ANTHEM
VA
05
—
5614180
—
VA
Enumeration date
07/14/2005
Last updated
02/07/2020
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