Provider Demographics
NPI:1851378624
Name:DILL, LAURIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:E
Last Name:DILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 MCGEHEE RD
Mailing Address - Street 2:P.O.BOX 11087
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2151
Mailing Address - Country:US
Mailing Address - Phone:334-280-3349
Mailing Address - Fax:334-281-2308
Practice Address - Street 1:2900 MCGEHEE RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2151
Practice Address - Country:US
Practice Address - Phone:334-280-3349
Practice Address - Fax:334-281-2308
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00012866207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL04-00924OtherUNITED HEALTHCARE
AL000034249Medicaid
AL04-00924OtherUNITED HEALTHCARE
AL000034249Medicaid