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Individual

DAVID W LAZAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2400 MOUNT ZION PKWY, JONESBORO, GA 30236-2500
(404) 365-0966
Mailing address
3495 PIEDMONT RD NE, ATLANTA, GA 30305-1717
(404) 364-7285

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
078072
GA
208800000X
Urology Physician
208800000X
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
064721700
FL
Enumeration date
02/20/2006
Last updated
09/13/2018
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