Provider Demographics
NPI:1205811528
Name:LAFON, SANDRA GARDNER (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:GARDNER
Last Name:LAFON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4477 SOUTH GETTYSBURG 48B
Mailing Address - Street 2:
Mailing Address - City:HEIDELBERG
Mailing Address - State:GERMANY
Mailing Address - Zip Code:69126
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:US ARMY HOSPITAL NACHRICHTEN KASERNE
Practice Address - Street 2:KARLSRUHER STRASSE 144
Practice Address - City:HEIDELBERG
Practice Address - State:GERMANY
Practice Address - Zip Code:69126
Practice Address - Country:DE
Practice Address - Phone:114-962-2117
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021429207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine