Active NPI
William Douglas Lazenby, MD
- Surgery Physician
- Griffin, GA
National Provider Identifier
1245286376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 051969
- Practice address
- 220 W College St Ste B
Griffin, GA 30224-4250 - Phone
- (770) 233-1080
- Fax
- (770) 233-3680
- NPI assigned
- May 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 051969 | GA | Primary |
Addresses
Primary practice location
220 W College St Ste B
Griffin, GA 30224-4250
Mailing address
220 W College St Ste B
Griffin, GA 30224-4250
Phone (770) 233-1080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202I025868 | Other | GA | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277164800000",
"number": "1245286376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 W COLLEGE ST STE B",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244250",
"telephone_number": "770-233-1080",
"fax_number": "770-233-3680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 W COLLEGE ST STE B",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244250",
"telephone_number": "770-233-1080",
"fax_number": "770-233-3680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZENBY",
"first_name": "WILLIAM",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2010-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "051969",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "202I025868",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Griffin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.