Individual
LAURA LYNN DOLLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
500 GYPSY LN, YOUNGSTOWN, OH 44504-1315
(330) 884-1000
Mailing address
3665 DEER RIDGE RUN, CUYAHOGA FLS, OH 44223
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.005729
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0929973
—
OH
01
—
942460636294
CARESOURCE
OH
01
—
P00250336
MEDICARE TRAVELERS RR-GA
OH
Enumeration date
07/19/2006
Last updated
02/20/2023
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