Provider Demographics
NPI:1043220833
Name:REESE, LAURA CZULEWICZ (DO)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CZULEWICZ
Last Name:REESE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SAINT CHRISTOPHER DR
Mailing Address - Street 2:MOB 3 SUITE 200
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7062
Mailing Address - Country:US
Mailing Address - Phone:606-833-5505
Mailing Address - Fax:
Practice Address - Street 1:700 SAINT CHRISTOPHER DR
Practice Address - Street 2:MOB 3 SUITE 200
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7062
Practice Address - Country:US
Practice Address - Phone:606-833-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02720207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64962871Medicaid
OH0126910Medicaid
KY0703301Medicare PIN
OH0126910Medicaid