Provider Demographics
NPI:1144288069
Name:LAZAR, ANTHONY L (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:L
Last Name:LAZAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1223 S GEAR AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1682
Mailing Address - Country:US
Mailing Address - Phone:319-754-4004
Mailing Address - Fax:319-753-5498
Practice Address - Street 1:1223 S GEAR AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1682
Practice Address - Country:US
Practice Address - Phone:319-754-4004
Practice Address - Fax:319-753-5498
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA23402207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00170916OtherRAILROAD MEDICARE
IA2201491Medicaid
IA37984OtherBLUE CROSS BLUE SHIELD
IA2201491Medicaid