MEDICARE: H LUCIUS LAFFITTE JR MD LLC

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	207Q00000X	Family Medicine Physician

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	:	1447490347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H LUCIUS LAFFITTE JR MD LLC

Provider Business Mailing Address
First Line	:	27B KEMMERLIN LN
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29907-2702
Country	:	US
Telephone Number	:	843-322-8477
Fax Number	:	843-322-8077

Provider Business Practice Location Address
First Line	:	27B KEMMERLIN LN
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29907-2702
Country	:	US
Telephone Number	:	843-322-8477
Fax Number	:	843-322-8077

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HENRY LUCIUS LAFFITTE JR.
Credential	:	MD
Telephone Number	:	843-322-8477

Provider Enumeration Date	:	03/05/2009
Last Update Date	:	03/05/2009

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