| Lafayette Clinic, Pa | |
|
2125 Valleygate Dr Suite 201 Fayetteville NC 28304-3753 | |
| (910) 323-1322 | |
| (910) 323-1510 |
| Full Name | Lafayette Clinic, Pa |
|---|---|
| Speciality | Allergy & Immunology |
| Location | 2125 Valleygate Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Douglas Wayne Whetsell (PRESIDENT) |
| Authorized Official Contact | 9103231322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lafayette Clinic, Pa Po Box 43905 Fayetteville NC 28309-3905 Ph: (910) 323-1322 | Lafayette Clinic, Pa 2125 Valleygate Dr Suite 201 Fayetteville NC 28304-3753 Ph: (910) 323-1322 |
| NPI Number | 1356455059 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 11/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356455059 | NPI | - | NPPES |
| CN6121 | Other | RAILROAD MEDICARE | |
| 890138G | Medicaid | NC | |
| 0138G | Other | BLUE CROSS BLUE SHIELD |
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