Individual
LAFAYETTE LYLE SMITH
Active
Individual
LAFAYETTE LYLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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