Provider Demographics
NPI:1396705612
Name:LAY, JOHN PRESTON JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PRESTON
Last Name:LAY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:695 STOCKBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-0300
Mailing Address - Country:US
Mailing Address - Phone:910-717-6106
Mailing Address - Fax:
Practice Address - Street 1:BLDG 5-4257
Practice Address - Street 2:BASTOGNE STREET EXTENSION
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-2575
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BL 8732578OtherDEA NUMBER