Provider Demographics
NPI:1912998204
Name:LAFFITTE, HENRY LUCIUS JR (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:LUCIUS
Last Name:LAFFITTE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:H
Other - Middle Name:LUCIUS
Other - Last Name:LAFFITTE
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10 B KEMMERLIN LANE
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-2702
Mailing Address - Country:US
Mailing Address - Phone:843-322-8477
Mailing Address - Fax:843-322-8077
Practice Address - Street 1:10B KEMMERLIN LANE
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-2702
Practice Address - Country:US
Practice Address - Phone:843-322-8477
Practice Address - Fax:843-322-8077
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15482207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCE98943Medicare UPIN