Individual
BRADFORD C LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
45 WELLS ST, SUITE 103, WESTERLY, RI 02891-2927
(401) 596-6330
(401) 348-0420
Mailing address
45 WELLS ST, SUITE 103, WESTERLY, RI 02891-2927
(401) 596-6330
(401) 348-0420
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
026027
CT
207RG0100X
Gastroenterology Physician
Primary
MD06550
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003050119
—
CT
05
—
BL24810
—
RI
Enumeration date
05/22/2006
Last updated
11/16/2012
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