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Individual

DR. BONNIE LOU LAUDENBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
841 29TH ST, ASHLAND, KY 41101-3019
(606) 324-1170
(606) 324-1077
Mailing address
841 29TH ST, ASHLAND, KY 41101-3019
(606) 324-1170
(606) 324-1077

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35503
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000107798
BLUE CROSS BLUE SHIELD
KY
01
4037021
AETNA
KY
05
64007560
KY
Enumeration date
05/10/2006
Last updated
11/26/2014
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