Provider Demographics
NPI:1457556862
Name:LAIBINIS, WALTER JOHN JR (DO)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:JOHN
Last Name:LAIBINIS
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:32-36 CENTRAL AVE
Mailing Address - Street 2:MEDICAL STAFF OFFICE
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-1840
Mailing Address - Country:US
Mailing Address - Phone:570-723-0104
Mailing Address - Fax:570-723-0118
Practice Address - Street 1:103 WEST AVE
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1358
Practice Address - Country:US
Practice Address - Phone:570-724-3744
Practice Address - Fax:570-724-2459
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2015-09-15
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Provider Licenses
StateLicense IDTaxonomies
PAOS014048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine