DAVID W LAZAN (NPI# 1871568303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871568303 |
| Entity Type | Individual |
| Full Name | DAVID W LAZAN |
| Credential | M.D. |
| Practice Address |
2400 Mount Zion Pkwy Jonesboro GA 30236-2500 |
| Mailing Address |
3495 Piedmont Rd Ne Atlanta GA 30305-1717 |
| Practice Telephone | 4043650966 |
| Mailing Telephone | 4043647285 |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2018-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 078072 | GA | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 208800000X | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 064721700 | 05 |
| Street Address |
2400 MOUNT ZION PKWY |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721113 | Hannah Yael Paull | Psychologist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2020-08-19 |
| 1497316343 | Alexandra Blackburn | Nurse Practitioner | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2019-06-21 |
| 1811459944 | Lisa Fraser-powell | Social Worker | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2019-04-06 |
| 1093244220 | Megan Deanne Griffin | Physician Assistant | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-06-10 |
| 1104358803 | Simone Keinia Sharp-bucknor | Registered Nurse | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-03-31 |
| 1740712454 | Lisa Pruitt | Registered Nurse | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-03-31 |
| 1063952752 | Kayla Randle | Pharmacist | 2400 Mount Zion Pkwy, Suite 116, Jonesboro, GA 30236-2500 | 2017-03-01 |
| 1952849531 | Anna Broadus | Nurse Practitioner | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-02-03 |
| 1649656653 | Hector George Clarke Jr. | Pharmacist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2015-08-03 |
| 1396139036 | Courtney Howard | Psychiatry & Neurology | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2015-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386986222 | Chul Nam Lee | Urology | 2016 Pine Forest Ct, Jonesboro, GA 30236-5416 | 2013-03-18 |
| 1487972527 | Rudolph Noah Bowens Jr. | Urology | 303 E Matthews Ave Ste 100, Jonesboro, AR 72401-3113 | 2010-05-13 |
| 1437348745 | Enoch Walden Williams | Urology | 3817 S Culberhouse Rd, Jonesboro, AR 72404-9067 | 2007-10-23 |
| 1053383174 | Joseph C Kueter | Urology | 303 E Matthews Ave, Suite 200, Jonesboro, AR 72401-3150 | 2006-02-02 |
| 1790116150 | St. Bernards Urology Associates, Inc. | Urology | 303 E Matthews Ave, Jonesboro, AR 72401-3150 | 2013-12-10 |
| 1558673889 | Emily Jacobs | Urology | 303 E Matthews Ave, Suite 100, Jonesboro, AR 72401-3150 | 2010-07-01 |
| 1912032657 | Arkansas Urology Clinic, Ltd | Urology | 1150 E Matthews Ave, Suite 203, Jonesboro, AR 72401-4314 | 2007-02-22 |
| 1568505543 | John Melvin Allen | Urology | 4802e Johnson Ave, Jonesboro, AR 72401-8413 | 2007-02-15 |
| 1578606109 | Michael Laurence Suminski | Urology | 4802e Johnson Ave, Jonesboro, AR 72401-8413 | 2007-02-14 |
| 1396717534 | Medical Plaza Urology Associates | Urology | 303 E Matthews Ave, Suite 200, Jonesboro, AR 72401-3150 | 2006-02-02 |
| Find all providers in JONESBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.