Doctor Name: | LON E LAFFERTY |
NPI Number: | 1194724229 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 24313 |
Business Practice Address: | 2160 Blacklog Rd Inez, KY - 412249019 |
Business Phone Number: | 6062955028 |
Business Fax Number: | 6066384502 |
Mailing Address: | Po Box 1304, INEZ |
State: | KY |
Postal Code: | 412241304 |
Phone Number: | 6062987405 |
Fax Number: | 6062983284 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 05/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | 24313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |