| Lazo Family Medicine Inc | |
|
55741 National Rd Bridgeport OH 43912 | |
| (740) 635-4572 | |
| (740) 635-4575 |
| Full Name | Lazo Family Medicine Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 55741 National Rd, Bridgeport, Ohio |
| Authorized Official Name and Position | Fausto J Lazo (MD PRESIDENT) |
| Authorized Official Contact | 7406354572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lazo Family Medicine Inc 55741 National Rd Bridgeport OH 43912-1528 Ph: (740) 635-4572 | Lazo Family Medicine Inc 55741 National Rd Bridgeport OH 43912 Ph: (740) 635-4572 |
| NPI Number | 1699858936 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 03/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699858936 | NPI | - | NPPES |
| 0458339 | Medicaid | OH | |
| 3810016451 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Bridgeport Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55741 National Rd, Bridgeport, OH 43912 Phone: 740-635-4572 Fax: 740-635-4575 |