Provider Demographics
NPI:1356330492
Name:LAFORCE, LINDA M (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:LAFORCE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:45 HOSPITAL CENTER CMNS
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2837
Mailing Address - Country:US
Mailing Address - Phone:843-689-2895
Mailing Address - Fax:843-715-2669
Practice Address - Street 1:100 BUCKWALTER PLACE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910
Practice Address - Country:US
Practice Address - Phone:843-836-7101
Practice Address - Fax:843-836-7112
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004524363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q47318Medicare UPIN
GA97WCGQVMedicare ID - Type Unspecified