Provider Demographics
NPI:1811928997
Name:LAUREL HIGHLANDS OBGYN, P.C.
Entity type:Organization
Organization Name:LAUREL HIGHLANDS OBGYN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GLAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-437-2147
Mailing Address - Street 1:1142 NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:HOPWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15445-2250
Mailing Address - Country:US
Mailing Address - Phone:724-437-2147
Mailing Address - Fax:724-438-8856
Practice Address - Street 1:1142 NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:HOPWOOD
Practice Address - State:PA
Practice Address - Zip Code:15445-2250
Practice Address - Country:US
Practice Address - Phone:724-437-2147
Practice Address - Fax:724-438-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007324620015Medicaid
PA1007324620017Medicaid
PA876198OtherBLUE CROSS/BLUE SHIELD
PA1007324620018Medicaid
PA876198OtherBLUE CROSS/BLUE SHIELD
PA1007324620018Medicaid