Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 20041 | AZ |
Y | 208600000X | Surgeon | 20041 | AZ |
N | 2086S0129X | Vascular Surgeon | 20041 | AZ |
NPI | 1063440972 |
---|---|
Provider Name | Dr. Michael A Lavor |
First Address | Tucson, AZ 85710-1149 |
Second Address | Tucson, AZ 85710-1149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 22/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
203604285 | UNITED (01) | AZ |
2Z3171 | HEALTH NET (01) | AZ |
69472 | PACIFICARE (01) | AZ |
AZ0153300 | BCBS (01) | AZ |
E92887 | (02) | AZ |
O55823-22 | AHCCCS (01) | AZ |