Provider Demographics
NPI:1922533512
Name:LAUGHEY, BRIAN ANDREW
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANDREW
Last Name:LAUGHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-996-7076
Mailing Address - Fax:336-996-7832
Practice Address - Street 1:1710 KERNERSVILLE MEDICAL PKWY STE 205
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7156
Practice Address - Country:US
Practice Address - Phone:336-996-7076
Practice Address - Fax:336-996-7832
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-01118207R00000X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program