Provider Demographics
NPI:1013997444
Name:PUTNAM, LAURA FRANTZ (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:FRANTZ
Last Name:PUTNAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FRANTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:4095 S LEE ST
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3647
Practice Address - Country:US
Practice Address - Phone:770-932-8519
Practice Address - Fax:770-533-4798
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031651208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA302586OtherWELLCARE
GA000476649CMedicaid
GA000476649DMedicaid
GA10032980OtherAMERIGROUP
GA000476649BMedicaid
GA000476649FMedicaid
GA6980458OtherCIGNA
GA000476649EMedicaid
GA2063542OtherAETNA HMO
GA000476649GMedicaid
GA1202904OtherUNITED HEALTHCARE
GA302569OtherWELLCARE
GA302572OtherWELLCARE
GA302565OtherWELLCARE
GA4216197OtherAETNA PPO
GA52660376OtherBCBS
GA000476649GMedicaid
GA000476649FMedicaid