Provider Demographics
NPI:1750444139
Name:LAU, HENRY S (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:S
Last Name:LAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:629-208-6008
Practice Address - Street 1:110 SAINT BLAISE RD STE 200
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-4594
Practice Address - Country:US
Practice Address - Phone:615-230-8070
Practice Address - Fax:615-452-1774
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2023-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD36080207Q00000X
TN36080207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3876813Medicaid
5332474OtherCIGNA
7840500OtherAETNA
4067679OtherBCBS
7840500OtherAETNA
TNH68425Medicare UPIN