Provider Demographics
NPI:1700040946
Name:LONDRA, LAURA (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LONDRA
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 1:4830 KNIGHTSBRIDGE BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-4339
Mailing Address - Country:US
Mailing Address - Phone:614-451-2280
Mailing Address - Fax:614-451-4229
Practice Address - Street 1:4830 KNIGHTSBRIDGE BLVD STE E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2300
Practice Address - Country:US
Practice Address - Phone:614-451-2280
Practice Address - Fax:614-451-4229
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125575207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology