Provider Demographics
NPI:1619912250
Name:LAUBAUGH, RICHARD MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:LAUBAUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 SW MCI WAY
Mailing Address - Street 2:MEDICAL DEPARTMENT
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-6806
Mailing Address - Country:US
Mailing Address - Phone:850-973-5519
Mailing Address - Fax:386-329-9797
Practice Address - Street 1:382 SW MCI WAY
Practice Address - Street 2:MEDICAL DEPARTMENT
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-3234
Practice Address - Country:US
Practice Address - Phone:850-973-5519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48837207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043852900Medicaid