Provider Demographics
NPI:1013006618
Name:LAPOINTE, STEPHAN J (DPM/PHD)
Entity Type:Individual
Prefix:
First Name:STEPHAN
Middle Name:J
Last Name:LAPOINTE
Suffix:
Gender:M
Credentials:DPM/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 W 10TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2640
Mailing Address - Country:US
Mailing Address - Phone:706-232-3888
Mailing Address - Fax:706-232-8099
Practice Address - Street 1:1100 MARTHA BERRY BLVD NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1612
Practice Address - Country:US
Practice Address - Phone:706-232-3888
Practice Address - Fax:877-795-8359
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000831213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00955721GMedicaid
GA00955721DMedicaid
GA48SCCMZMedicare PIN
GA00955721GMedicaid