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Individual

DR. GADDY LASSITER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
103 E MAIN ST, HARRELLSVILLE, NC 27942-9201
(252) 356-6544
(252) 356-9907
Mailing address
103 E MAIN ST, HARRELLSVILLE, NC 27942-9201
(252) 356-6544
(252) 356-9907

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
009900580
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1216W
BC/BS IND. #
NC
05
891216W
NC
Enumeration date
12/19/2005
Last updated
07/23/2010
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