Individual
DR. LAURA ANN O'GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-6814
(573) 815-3716
Mailing address
PO BOX 10200, COLUMBIA, MO 65205-4003
(573) 815-9700
(573) 815-0700
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
107741
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11060392
CAQHPROVIDER ID
—
01
—
17315
ANTHEM BCBS PIN
—
01
—
17676
HEALTHCARE USA PIN
—
01
—
271875
HEALTHLINK PIN
—
Enumeration date
10/23/2006
Last updated
07/08/2007
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