Provider Demographics
NPI:1033461900
Name:TRUNK, LAURA ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELLEN
Last Name:TRUNK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-1706
Mailing Address - Country:US
Mailing Address - Phone:504-833-3617
Mailing Address - Fax:904-376-8770
Practice Address - Street 1:1200 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-1706
Practice Address - Country:US
Practice Address - Phone:504-833-3617
Practice Address - Fax:904-376-8770
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine