Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD031520 | TN |
NPI | 1003826470 |
---|---|
Provider Name | Laura Leigh Urban |
First Address | Greeneville, TN 37745-4341 |
Second Address | Greeneville, TN 37745-4332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 24/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G71289 | (02) | TN |