Provider Demographics
NPI:1083640924
Name:RAMSBACHER, LAURIE (MD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:RAMSBACHER
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 1:659 S SAHUARO DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-7329
Mailing Address - Country:US
Mailing Address - Phone:602-304-0014
Mailing Address - Fax:602-304-0190
Practice Address - Street 1:1501 W FOUNTAINHEAD PKWY
Practice Address - Street 2:SUITE 295
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1868
Practice Address - Country:US
Practice Address - Phone:866-495-6738
Practice Address - Fax:800-398-6182
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207632084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ116469Medicaid