Provider Demographics
NPI:1437141454
Name:LAZENBY, KATHY SAWYER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:SAWYER
Last Name:LAZENBY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BLUMBERG DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-3003
Mailing Address - Country:US
Mailing Address - Phone:334-677-7299
Mailing Address - Fax:334-677-7299
Practice Address - Street 1:4119 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1023
Practice Address - Country:US
Practice Address - Phone:334-793-1316
Practice Address - Fax:334-793-4920
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist