Provider Demographics
NPI:1770809170
Name:LAUN, FREDERICK MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:MATTHEW
Last Name:LAUN
Suffix:
Gender:M
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:P.O.B. 328
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-0328
Mailing Address - Country:US
Mailing Address - Phone:912-852-5280
Mailing Address - Fax:912-852-9280
Practice Address - Street 1:102 TURKEY TRAIL
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0328
Practice Address - Country:US
Practice Address - Phone:912-852-5280
Practice Address - Fax:912-852-9280
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA020761207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery