Healthcare Provider Details

I. General information

NPI: 1467407296
Provider Name (Legal Business Name): LAURA JEAN SCHILLING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS LAURA JEAN HOVING

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4785 N 1ST ST
FRESNO CA
93726-0513
US

IV. Provider business mailing address

4785 N 1ST ST
FRESNO CA
93726-0513
US

V. Phone/Fax

Practice location:
  • Phone: 559-448-4555
  • Fax: 559-448-4754
Mailing address:
  • Phone: 559-448-4555
  • Fax: 559-448-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA80571
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: