Individual
LAURA L VANDENHEEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5658 HIGHWAY 260, SUITE 7, LAKESIDE, AZ 85929-5189
(928) 537-3399
(928) 537-0475
Mailing address
5658 HIGHWAY 260, SUITE 7, LAKESIDE, AZ 85929-5189
(928) 537-3399
(928) 537-0475
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26282
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418021
—
AR
01
—
Z1096282
STATE COMP FUND
AR
Enumeration date
02/16/2006
Last updated
03/07/2023
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