Individual
MR. DEREK AARON LAFONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3696 WHEELER RD, AUGUSTA, GA 30909-6520
(706) 736-1830
(706) 650-7553
Mailing address
3696 WHEELER RD, AUGUSTA, GA 30909-6520
(706) 736-1830
(706) 650-7553
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004721
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
639124321A
—
GA
05
—
639124321B
—
GA
05
—
639124321C
—
GA
Enumeration date
02/09/2006
Last updated
07/21/2021
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