MEDICARE: MR. GREGORY SYDNOR LAFFITTE PA-C

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
1	363AM0700X	Medical Physician Assistant	004152	GA
2	363A00000X	Physician Assistant	PA9104253	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1841261336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY SYDNOR LAFFITTE PA-C

Provider Business Mailing Address
First Line	:	2633 CENTENNIAL DRIVE
Second Line	:	SUITE 100
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-0585
Country	:	US
Telephone Number	:	850-431-5404
Fax Number	:	850-431-4794

Provider Business Practice Location Address
First Line	:	1300 MICCOSUKEE RD
Second Line	:	HOSPITALISTS GROUP
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5054
Country	:	US
Telephone Number	:	850-431-4556
Fax Number	:	850-431-6315

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	02/27/2017

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