Provider Demographics
NPI:1447244876
Name:LAPLACE, LILLIA T (MD)
Entity Type:Individual
Prefix:DR
First Name:LILLIA
Middle Name:T
Last Name:LAPLACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 602381
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2381
Mailing Address - Country:US
Mailing Address - Phone:828-349-6611
Mailing Address - Fax:828-349-6615
Practice Address - Street 1:55 MEDICAL PARK DR
Practice Address - Street 2:#108
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2651
Practice Address - Country:US
Practice Address - Phone:828-349-6611
Practice Address - Fax:828-349-6615
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01454207RC0000X, 207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH86115Medicare UPIN
FL78719OtherBCBS
FL266824600Medicaid
FL78719ZMedicare ID - Type Unspecified