1134165608 NPI number — LAURA L HOCTER-OUSLEY DO

Table of content: LAURA L HOCTER-OUSLEY DO (NPI 1134165608)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134165608 NPI number — LAURA L HOCTER-OUSLEY DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOCTER-OUSLEY
Provider First Name:
LAURA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134165608
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5450 FRANTZ RD STE 360
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43016-4141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-544-6155
Provider Business Mailing Address Fax Number:
614-544-6370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 W GREEN DR STE 246
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45701-2974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-593-2516
Provider Business Practice Location Address Fax Number:
740-593-2905
Provider Enumeration Date:
06/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  02924 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 34007533 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3810003420 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2280697 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64044845 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".