Healthcare Provider Details

I. General information

NPI: 1457302804
Provider Name (Legal Business Name): LONNIE W LASSITER II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 SPARKS DR
FOREST CITY NC
28043-9021
US

IV. Provider business mailing address

112 SPARKS DR
FOREST CITY NC
28043-9021
US

V. Phone/Fax

Practice location:
  • Phone: 828-351-6000
  • Fax: 828-894-5864
Mailing address:
  • Phone: 828-351-6000
  • Fax: 828-287-7436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2000-00509
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number200000509
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: