Provider Demographics
NPI:1538571682
Name:LAZARUS, IRENE (MD, MPH)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 UNION SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2084
Mailing Address - Country:US
Mailing Address - Phone:615-206-1100
Mailing Address - Fax:
Practice Address - Street 1:1005 UNION SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2084
Practice Address - Country:US
Practice Address - Phone:615-206-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN684192083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine