Individual
GORDON KYLE LAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
820 S BOYLAN AVE, 2 EAST, RALEIGH, NC 27603-2246
(919) 733-5540
(919) 733-9020
Mailing address
820 S BOYLAN AVE, 2 EAST, RALEIGH, NC 27603-2246
(919) 733-5540
(919) 733-9020
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24925
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8951186
—
NC
Enumeration date
02/17/2009
Last updated
02/17/2009
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