Provider Demographics
NPI:1578516365
Name:THOMASON, LAURA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:THOMASON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:3701 S CLARKSON ST STE 400
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3960
Practice Address - Country:US
Practice Address - Phone:303-761-7797
Practice Address - Fax:303-789-2995
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0025139207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD28732Medicare UPIN
COL9338Medicare PIN