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NPI Code Detail

MEDICARE: DR. JACQUES PHILIPPE LAGUERRE MD

MEDICARE: DR. JACQUES PHILIPPE LAGUERRE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician200601831NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134257199
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUES PHILIPPE LAGUERRE MD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-384-1140
Fax Number : 704-384-1141
Provider Business Practice Location Address
First Line : 1995 WELLNESS BLVD
Second Line : STE 110, BLDG B
City : MONROE
State : NC
Zip : 28110-7769
Country : US
Telephone Number : 704-384-1140
Fax Number : 704-384-1141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 10/28/2020

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