Provider Demographics
NPI:1508066648
Name:LAFFERTY, HOWARD WESLEY JR (DO)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:WESLEY
Last Name:LAFFERTY
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1310
Mailing Address - Country:US
Mailing Address - Phone:304-720-3555
Mailing Address - Fax:304-720-2556
Practice Address - Street 1:509 2ND AVE
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1310
Practice Address - Country:US
Practice Address - Phone:304-720-3555
Practice Address - Fax:304-720-2556
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV2326207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine