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Individual

LAFAYETTE LYLE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4515 PREMIER DR, SUITE 204, HIGH POINT, NC 27265-8357
(336) 802-2075
(336) 802-2076
Mailing address
1701 WESTCHESTER DRIVE, SUITE 850, HIGH POINT, NC 27262-7254
(336) 802-2400
(336) 802-2534

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22053
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110115006
RR MEDICARE
NC
01
1212660010
DME
NC
05
8977970
NC
Enumeration date
07/10/2006
Last updated
11/30/2012
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