Provider Demographics
NPI:1679564678
Name:ZSOM, LAJOS (MD)
Entity type:Individual
Prefix:DR
First Name:LAJOS
Middle Name:
Last Name:ZSOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:P.O. BOX 24146
Mailing Address - Street 2:UNIVERSITY PHYSICIANS, PLLC
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225-4146
Mailing Address - Country:US
Mailing Address - Phone:601-984-5687
Mailing Address - Fax:601-984-5765
Practice Address - Street 1:2500 NORTH STATE STREET
Practice Address - Street 2:DEPARTMENT OF MEDICINE DIVISION OF NEPHROLOGY
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-984-5687
Practice Address - Fax:601-984-5765
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2008-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35087077174400000X
MS19802207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS512I110110OtherMEDICARE PTAN
MS00635837Medicaid
OH35087077OtherSTATE LICENSE
OHG63530Medicare UPIN