Healthcare Provider Details

I. General information

NPI: 1235716663
Provider Name (Legal Business Name): EMILY A. LAUGGES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY A WADE MD

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 WATSON RD STE 103
SAINT LOUIS MO
63119-9804
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 314-633-8670
  • Fax:
Mailing address:
  • Phone: 314-633-8670
  • Fax: 314-633-8675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2024017135
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: