Provider Demographics
NPI:1598225492
Name:LING, LAURA A KURATA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A KURATA
Last Name:LING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 GALLATIN PIKE N
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2001
Mailing Address - Country:US
Mailing Address - Phone:615-988-4055
Mailing Address - Fax:877-721-6419
Practice Address - Street 1:2009 GALLATIN PIKE N
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2001
Practice Address - Country:US
Practice Address - Phone:615-988-4055
Practice Address - Fax:877-721-6419
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0094913207Q00000X
TN68125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine