Individual provider · Type 1 NPI
John Nelson Lazenby Iii, MHS, PA-C
Surgical Physician Assistant · Mcalester, OK
NPI number
1336779206
Active
Practice location
4 E Clark Bass Blvd Ste 302
Mcalester, OK 74501-4269
Mailing address
6708 Trevi Ct
Oklahoma City, OK 73116-2604
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 3133 (OK) |
Surgical Physician Assistant: Definition to come...
About NPI 1336779206
John Nelson Lazenby Iii, MHS, PA-C's National Provider Identifier is 1336779206, issued on Jan 20, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Mcalester, OK. The record was last updated on Jan 20, 2020.