Provider Demographics
NPI:1003875204
Name:LIZOTTE, EARL H JR (OD)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:H
Last Name:LIZOTTE
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:176 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027
Mailing Address - Country:US
Mailing Address - Phone:413-527-4881
Mailing Address - Fax:413-527-4892
Practice Address - Street 1:176 MAIN ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027
Practice Address - Country:US
Practice Address - Phone:413-527-4881
Practice Address - Fax:413-527-4892
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2057152W00000X
MAMA2057152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7262815004OtherCIGNA HEALTH CARE
MAW15085OtherBLUE CROSS BLUE SHIELD
782883OtherCONNECTICARE
MA000000024532OtherBMC HEALTH NET PLAN
00000314701OtherUNITED HEALTH CARE
MA0309702Medicaid
042349836OtherCIGNA HEALTH CARE
799324OtherTUFTS HEALTH PLAN
18888OtherSPECTERA
MA967179OtherNETWORK HEALTH
MA0309702Medicaid
051758Medicare Oscar/Certification
799324OtherTUFTS HEALTH PLAN
18888OtherSPECTERA
042349836OtherCIGNA HEALTH CARE