Individual
LAURA ANN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5050 POWDERHOUSE RD, CHEYENNE, WY 82009-4800
(307) 772-8226
(307) 634-1271
Mailing address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7322
(307) 778-7531
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
5157A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104601200
—
WY
01
—
222LB92
SUBSTANCE CONTROL
WY
01
—
5157A
STATE LICENSE
WY
Enumeration date
11/23/2005
Last updated
06/17/2011
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