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General NPI Number Information
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NPI Number | 1104098110
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Entity Type | Individual
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Provider Name | LAURA TERESA WITHERS M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1 HOSPITAL DR DDEPARTMENT OF FAMILT MEDICINE
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City | COLUMBIA
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State | MO
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Zip | 65212-1000
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Country | US
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Telephone | 573-884-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 S. SCOTT BLVD 12B
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City | COLUMBIA
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State | MO
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Zip | 65203
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Country | US
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Telephone | 917-650-5408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 002800501
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 2025045730
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 602330543
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | ME102332
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 602330543
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License Number State | WA
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