Provider Demographics
NPI:1730142175
Name:LAJOIE, KENNETH THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:THOMAS
Last Name:LAJOIE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3/22 ROBERT AVE
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW
Mailing Address - State:SOUTH AUSTRALIA
Mailing Address - Zip Code:5087
Mailing Address - Country:AU
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 WOODWORTH AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5360
Practice Address - Country:US
Practice Address - Phone:603-436-8605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA131205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine