MEDICARE: DR. CHRISTOPHER LAVERNE LARISCY 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
1	207L00000X	Anesthesiology Physician	200101230	NC
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	200101230	NC

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	:	1407836125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER LAVERNE LARISCY MD

Provider Business Mailing Address
First Line	:	415 N CENTER ST
Second Line	:	STE 201
City	:	HICKORY
State	:	NC
Zip	:	28601-5036
Country	:	US
Telephone Number	:	828-327-8105
Fax Number	:	828-327-4245

Provider Business Practice Location Address
First Line	:	415 N CENTER ST
Second Line	:	STE 201
City	:	HICKORY
State	:	NC
Zip	:	28601-5036
Country	:	US
Telephone Number	:	828-327-8105
Fax Number	:	828-327-4245

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/01/2011

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Directions to “ DR. CHRISTOPHER LAVERNE LARISCY MD” Practice Location

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