Provider Demographics
NPI:1831142744
Name:ASHLAND WOMEN'S HEALTH
Entity Type:Organization
Organization Name:ASHLAND WOMEN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:LAUDENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-324-1170
Mailing Address - Street 1:841 29TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-3019
Mailing Address - Country:US
Mailing Address - Phone:606-324-1170
Mailing Address - Fax:606-324-1077
Practice Address - Street 1:841 29TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3019
Practice Address - Country:US
Practice Address - Phone:606-324-1170
Practice Address - Fax:606-324-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35503207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64007560Medicaid
KY000000107798OtherANTHEM
DG7394Medicare PIN
KY00234Medicare PIN
KYA56545Medicare UPIN