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NPI Code Detail

MEDICARE: LAURA FAYE GEPHART MD

MEDICARE: LAURA FAYE GEPHART MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianMD469792PA
2207V00000XObstetrics & Gynecology PhysicianQ0261TX
32088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianQ0261TX
42088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianMD469792PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1H08HJ61101OTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568783306
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA FAYE GEPHART MD
Provider Business Mailing Address
First Line : 311 W 24TH ST STE 101
Second Line :
City : ERIE
State : PA
Zip : 16502-2668
Country : US
Telephone Number : 814-452-4214
Fax Number : 814-459-7823
Provider Business Practice Location Address
First Line : 311 W 24TH ST STE 101
Second Line :
City : ERIE
State : PA
Zip : 16502-2668
Country : US
Telephone Number : 814-452-4214
Fax Number : 814-459-7823
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2010
Last Update Date : 10/02/2020

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Directions to “ LAURA FAYE GEPHART MD” Practice Location

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