Provider Demographics
NPI:1003826470
Name:URBAN, LAURA LEIGH (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEIGH
Last Name:URBAN
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 1:1406 TUSCULUM BLVD STE 1000
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4341
Mailing Address - Country:US
Mailing Address - Phone:423-693-6848
Mailing Address - Fax:423-787-7210
Practice Address - Street 1:1406 TUSCULUM BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4332
Practice Address - Country:US
Practice Address - Phone:423-693-6848
Practice Address - Fax:423-787-7210
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD031520207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG71289Medicare UPIN
TNG71289Medicare UPIN