Individual
MS. LAURIE ANN DESHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1600 HIGHWAY 17 N, SURFSIDE BEACH, SC 29575-6015
(843) 238-1461
(843) 828-0622
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2971
SC
363A00000X
Physician Assistant
PA01446
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182007801
—
TX
Enumeration date
07/18/2006
Last updated
11/01/2024
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