| Ivan E. Lazo, M.d., P.c. | |
|
441 Piney Forest Rd Suite B Danville VA 24540-4154 | |
| (434) 799-5700 | |
| (434) 799-4693 |
| Full Name | Ivan E. Lazo, M.d., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 441 Piney Forest Rd, Danville, Virginia |
| Authorized Official Name and Position | Stephanie Williams (OFFICE MANAGER) |
| Authorized Official Contact | 4347995700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivan E. Lazo, M.d., P.c. 441 Piney Forest Rd Suite B Danville VA 24540-4154 Ph: (434) 799-5700 | Ivan E. Lazo, M.d., P.c. 441 Piney Forest Rd Suite B Danville VA 24540-4154 Ph: (434) 799-5700 |
| NPI Number | 1952593147 |
|---|---|
| Provider Enumeration Date | 08/13/2007 |
| Last Update Date | 06/08/2023 |
| Medicare PECOS PAC ID | 2567490840 |
|---|---|
| Medicare Enrollment ID | O20050728000394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952593147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101051102 (Virginia) | Primary |
| Provider Name | Ivan Eduardo Lazo |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1649237157 PECOS PAC ID: 0648208934 Enrollment ID: I20100914000534 |
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