MEDICARE: JOSEPH W LAVORI D.O.

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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	39619	GA

General Provider Information

NPI Number	:	1922124254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH W LAVORI D.O.

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DRIVE
Second Line	:	SUITE 1200 WEST TOWER
City	:	ADDISON
State	:	TX
Zip	:	75001
Country	:	US
Telephone Number	:	800-232-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	5670 FULTON INDUSTRIAL BLVD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30336-2659
Country	:	US
Telephone Number	:	615-778-4066
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	02/17/2009

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