Lynette Hazelbaker MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LYNETTE HAZELBAKER MD PC

Practice address

3508 S Lafountain St
Kokomo, IN 46902-3803

Phone

(765) 864-8727

Fax

(765) 453-8638

NPI assigned

Sep 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lynette Hazelbaker, MD

Title

Provider

Phone

(765) 864-8727

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679880058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-864-8727",
            "fax_number": "765-453-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023803",
            "telephone_number": "765-864-8727",
            "fax_number": "765-453-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNETTE HAZELBAKER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HAZELBAKER",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "765-864-8727",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100137490B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.