Provider Demographics
NPI:1942025697
Name:FORD, LALITA CATHERINE (PA-C)
Entity type:Individual
Prefix:
First Name:LALITA
Middle Name:CATHERINE
Last Name:FORD
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4922 OLD PAGE RD APT 321
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8096
Mailing Address - Country:US
Mailing Address - Phone:260-348-6304
Mailing Address - Fax:
Practice Address - Street 1:120 W MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4906
Practice Address - Country:US
Practice Address - Phone:252-940-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant