Provider Demographics
NPI:1558786186
Name:LAZZARA, LOUIS JAMES JR (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:JAMES
Last Name:LAZZARA
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-2503
Mailing Address - Country:US
Mailing Address - Phone:804-541-0918
Mailing Address - Fax:
Practice Address - Street 1:13901 COALFIELD COMMONS PL STE 102
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-1219
Practice Address - Country:US
Practice Address - Phone:804-378-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01022042052084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program