Individual
DAVID LAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 536-2146
(770) 536-7895
Mailing address
PO BOX 2938, GAINESVILLE, GA 30503-2938
(770) 536-2146
(770) 536-7895
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002357
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001515A
—
GA
05
—
100001517A
—
GA
Enumeration date
06/14/2006
Last updated
11/07/2007
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