Organization
LAURINBURG ENT CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK K LAVIGNE M.D. (OWNER)
(910) 610-4368
Entity
Organization
Contact information
Practice address
1705 BERWICK DR # B, LAURINBURG, NC 28352-5523
(910) 610-4368
(910) 610-4388
Mailing address
1705 BERWICK DR # B, LAURINBURG, NC 28352-5523
(910) 610-4368
(910) 610-4388
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
9400093
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890123J
—
NC
Enumeration date
03/11/2007
Last updated
01/07/2008
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