Provider Demographics
NPI:1689676207
Name:DEERFIELD, LAURIE J (DO)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:J
Last Name:DEERFIELD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:J
Other - Last Name:PETERSON-DEERFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:180 ACADEMY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3183
Mailing Address - Country:US
Mailing Address - Phone:207-554-2352
Mailing Address - Fax:207-554-2351
Practice Address - Street 1:710 BUCKSPORT RD
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-2722
Practice Address - Country:US
Practice Address - Phone:207-667-6890
Practice Address - Fax:207-667-6457
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS80792084P0800X
NJ25MB074192084P0800X, 2084P0800X
MEDO31562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry