Provider Demographics
NPI:1609862473
Name:LAVIGNE, GREGORY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:LAVIGNE
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:PO BOX 27877
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0877
Mailing Address - Country:US
Mailing Address - Phone:828-694-8685
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:21 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-274-4555
Practice Address - Fax:828-274-8348
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01080207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2604186Medicaid
WV0097851000Medicaid
PA1013996700001Medicaid
PA095714NH3Medicare PIN
WV0097851000Medicaid
OH2604186Medicaid