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LAFAYETTE CLINIC PA NPI 1356455059


NPI Information

NPI: 1356455059
Provider Name: LAFAYETTE CLINIC, PA
Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization
Address:
2125 VALLEYGATE DR
SUITE 201
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 323-1322
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LAFAYETTE CLINIC, PA is an allergy immunology in Fayetteville, NC. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. LAFAYETTE CLINIC, PA NPI is 1356455059. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2125 VALLEYGATE DR
SUITE 201
FAYETTEVILLE, NC
ZIP 28304-753
Phone: (910) 323-1322
Fax: (910) 323-1510

The provider's authorized official is Douglas Wayne Whetsell .
The authorized official title is President and has the following contact phone number (910) 323-1322.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 11/18/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207RP1001XInternal MedicinePulmonary DiseaseNo
3207RR0500XInternal MedicineRheumatologyNo
42080P0201XPediatricsPediatric Allergy/ImmunologyNo
52080P0214XPediatricsPediatric PulmonologyNo
6207K00000XAllergy & ImmunologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10138GOTHERBLUE CROSS BLUE SHIELD
2230511MEDICARE ID-TYPE UNSPECIFIED
3CN6121OTHERRAILROAD MEDICARE
4890138GMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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