Provider Demographics
NPI:1386831253
Name:LAZZERINI, FRANK D (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:D
Last Name:LAZZERINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7880 LINCOLE PL
Mailing Address - Street 2:COMMUNITY ACTION AGENCY
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-8322
Mailing Address - Country:US
Mailing Address - Phone:330-424-5686
Mailing Address - Fax:330-424-4012
Practice Address - Street 1:7880 LINCOLE PL
Practice Address - Street 2:COMMUNITY ACTION AGENCY
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-8322
Practice Address - Country:US
Practice Address - Phone:330-424-5686
Practice Address - Fax:330-424-4012
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2016-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35092741207Q00000X
OH35-092741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2983393Medicaid
OH2983393Medicaid