Provider Demographics
NPI:1124049333
Name:LAUER, CRAIG (MD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:LAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SOUTH 15TH STREET
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401
Mailing Address - Country:US
Mailing Address - Phone:307-347-5810
Mailing Address - Fax:307-347-5808
Practice Address - Street 1:400 SOUTH 15TH STREET
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401
Practice Address - Country:US
Practice Address - Phone:307-347-5810
Practice Address - Fax:307-347-5808
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009146Medicaid
NHRE4017Medicare PIN
G22694Medicare UPIN