Provider Demographics
NPI:1992790521
Name:LAUZON, JOHN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:LAUZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2200 E. PARRISH AVE
Mailing Address - Street 2:BLDG B, STE 101
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1449
Mailing Address - Country:US
Mailing Address - Phone:270-683-3232
Mailing Address - Fax:270-852-1600
Practice Address - Street 1:2200 E. PARRISH AVE
Practice Address - Street 2:BLDG B, STE 101
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1449
Practice Address - Country:US
Practice Address - Phone:270-683-3232
Practice Address - Fax:270-852-1600
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31795208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1069653OtherKY PASS-PORT NON-PARTICI
KY64879026Medicaid
00000051445OtherID BLUE CROSS INS
KY00000051445OtherID BLUE CROSS INSURANCE
KY64879026Medicaid
KY00000051445OtherID BLUE CROSS INSURANCE