Provider Demographics
NPI:1548600208
Name:LAUDERT, STEPHANIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:LAUDERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:CURRY MEDICAL PRACTICE
Mailing Address - Street 2:94220 4TH STREET
Mailing Address - City:GOLD BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97444
Mailing Address - Country:US
Mailing Address - Phone:541-247-3910
Mailing Address - Fax:541-247-3109
Practice Address - Street 1:CURRY MEDICAL PRACTICE
Practice Address - Street 2:94220 4TH STREET
Practice Address - City:GOLD BEACH
Practice Address - State:OR
Practice Address - Zip Code:97444
Practice Address - Country:US
Practice Address - Phone:541-247-3910
Practice Address - Fax:541-247-3109
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD182805207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD182805OtherOREGON MEDICAL BOARD
OR500713549Medicaid
OR1487696985OtherCURRY GENERAL HOSPITAL NPI
OR1346486818OtherCURRY MEDICAL PRACTICE