Individual
LORA LEE THAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1451 EL CAMINO REAL, THE VILLAGES, FL 32159
(352) 751-8506
(352) 751-8516
Mailing address
3361 TRULUCK PL, OXFORD, FL 34484-3493
(419) 356-4767
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
35071671T
OH
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME139140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2254715
—
OH
Enumeration date
06/15/2005
Last updated
03/13/2019
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