IndividualActive
Nicholas Lezama, MD
NPI 1619958170 · Aerospace Medicine Physician · O Fallon, IL
Provider details
- NPI number
- 1619958170
- Entity type
- Individual
- Primary specialty
- Aerospace Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 77082 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
901 Thornbury Pl
O Fallon, IL 62269-6811
Phone: (618) 229-5220
Approximate (ZIP-level) locationGet directions
Mailing address
901 Thornbury Pl
O Fallon, IL 62269-6811
Registry dates
- Enumerated
- 2005-11-10
- Last updated
- 2009-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.