Provider Demographics
NPI:1841209954
Name:LAFON, GEORGE I (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:I
Last Name:LAFON
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 1:905S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-4037
Mailing Address - Country:US
Mailing Address - Phone:575-543-7208
Mailing Address - Fax:575-543-7250
Practice Address - Street 1:850 W FLORIDA ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-4558
Practice Address - Country:US
Practice Address - Phone:575-544-2800
Practice Address - Fax:575-544-2801
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM81-71207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM48702Medicaid
NM26393Medicaid
NM48702Medicaid
NM26393Medicaid