Provider Demographics
NPI:1114363827
Name:LATTING, JOHN WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WESLEY
Last Name:LATTING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6745 FOPPIANO LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-9411
Mailing Address - Country:US
Mailing Address - Phone:205-746-7756
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN ROAD DUKE RADIOLOGY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-5504
Practice Address - Country:US
Practice Address - Phone:918-684-7293
Practice Address - Fax:919-684-7151
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-022102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty