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General NPI Number Information
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NPI Number | 1144719469
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Entity Type | Individual
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Provider Name | BRIAN LAUER DO
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Gender | Male
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 275 W BASSETT RD STE 3
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City | SHELBYVILLE
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State | IN
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Zip | 46176-8575
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Country | US
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Telephone | 317-421-3265
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Fax | 317-398-1872
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Provider Business Mailing Address
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Address Line | 30 W RAMPART ST STE 200
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City | SHELBYVILLE
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State | IN
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Zip | 46176-8846
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Country | US
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Telephone | 317-421-2012
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Fax | 317-398-1851
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02005782A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 02005782A
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License Number State | IN
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