MEDICARE: DR. GEORGE I LAFON 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	207Q00000X	Family Medicine Physician	81-71	NM

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841209954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE I LAFON MD

Provider Business Mailing Address
First Line	:	905S 8TH ST
Second Line	:
City	:	DEMING
State	:	NM
Zip	:	88030-4037
Country	:	US
Telephone Number	:	575-543-7208
Fax Number	:	575-543-7250

Provider Business Practice Location Address
First Line	:	850 W FLORIDA ST
Second Line	:
City	:	DEMING
State	:	NM
Zip	:	88030-4558
Country	:	US
Telephone Number	:	575-544-2800
Fax Number	:	575-544-2801

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	10/19/2015

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Directions to “ DR. GEORGE I LAFON MD” Practice Location

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