Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 24313 | KY |
NPI | 1194724229 |
---|---|
Provider Name | Lon E Lafferty |
First Address | Inez, KY 41224-1304 |
Second Address | Inez, KY 41224-9019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64243132 | (05) | KY |
C75680 | (02) | KY |