Dewayne Charles Lazenby MD

NPI 1073507364 - Pediatrics - 208000000X

NPI Details
NPI 1073507364
Gender Male
Enumeration Date 09/01/2005
Last Updated 08/03/2015
Entity Type Individual
Active Over 11 years ago
Practice Location
5955 ZEAMER AVE
673D MDG
JBER AK, 99506-3702, US
Phone (907) 580-2908
Fax
Business Location
5955 ZEAMER AVE
673D MDG
JBER AK, 99506-3702, US
Phone (907) 580-2908
Fax (801) 586-4018
Toxanomy
Taxonomy Code 208000000X
License State Utah
License Number 58873941205
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According to our database, Dr. Dewayne Charles Lazenby MD NPI is 1073507364, taxonomy code is 208000000X and license number is 58873941205, license state is located at Utah. Dewayne Charles Lazenby MD physically located at 5955 Zeamer Ave, Jber AK, 99506-3702. NPI Number Dewayne Charles Lazenby MD has the Individual type.

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1073507364 NPI number is provided on an as is basis without warranty of any kind. 1073507364 is maintained by the National Plan & Provider Enumeration System. The contents of Dewayne Charles Lazenby MD are for informational purposes only.