Provider Demographics
NPI:1598010217
Name:LASSITER, ALAN KENT (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:KENT
Last Name:LASSITER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8311 BRIER CREEK PKWY
Mailing Address - Street 2:STE 105-367
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7328
Mailing Address - Country:US
Mailing Address - Phone:919-280-5643
Mailing Address - Fax:
Practice Address - Street 1:10106 RAVEN TREE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8206
Practice Address - Country:US
Practice Address - Phone:919-280-5643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF97122080P0203X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine