Basic Information
| Provider Information | |||||||||
| NPI: | 1659419729 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STADLER | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | PATRICIA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 ROSE ST | ||||||||
| Address2: | MN104E | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592577704 | ||||||||
| FaxNumber: | 8592575549 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 ROSE ST | ||||||||
| Address2: | MN104E | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405360001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592577704 | ||||||||
| FaxNumber: | 8592575549 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 02/19/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0208X | 35.082911 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Infectious Diseases | 2080P0208X | 41745 | KY | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Infectious Diseases |
No ID Information.