Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD.24011 | AL |
Y | 2080P0214X | Pediatric Pulmonologist | MD.24011 | AL |
NPI | 1518915305 |
---|---|
Provider Name | David J Lozano |
First Address | Dothan, AL 36303-1980 |
Second Address | Dothan, AL 36303-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 14/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009961870 | (05) | AL |
1518915305 | TRICARE SOUTH (01) | AL |
515-33484 | BCBS (01) | AL |
515-48612 | BCBS (01) | AL |
7690295 | AETNA (01) | AL |
I04446 | (02) | AL |