| NPI | 1376598763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE A LAZOR Owner/Physician 502-883-6744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-10-19 |