Individual
MARK K LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1705 BERWICK DR # B, LAURINBURG, NC 28352-5523
(910) 610-4368
(910) 610-4388
Mailing address
1705 BERWICK DR # B, LAURINBURG, NC 28352-5523
(910) 610-4368
(910) 610-4388
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
9400093
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040008249
RAILROAD MEDICARE
NC
05
—
8951170
—
NC
05
—
N00093
—
SC
Enumeration date
03/11/2007
Last updated
01/07/2008
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