Healthcare Provider Details

I. General information

NPI: 1912326059
Provider Name (Legal Business Name): LAURA KYSER ROMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9797 TIMBER CIR STE B
SPANISH FORT AL
36527-5459
US

IV. Provider business mailing address

320 E 600 S
ST GEORGE UT
84770-3949
US

V. Phone/Fax

Practice location:
  • Phone: 251-405-3024
  • Fax: 334-218-5815
Mailing address:
  • Phone: 435-688-4850
  • Fax: 435-688-4851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1075048-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number51939
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: