Provider Demographics
NPI:1194043992
Name:LAUBINGER, KEITH ALLEN (IDC/RHO)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:ALLEN
Last Name:LAUBINGER
Suffix:
Gender:M
Credentials:IDC/RHO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 BATTLESHIP DR
Mailing Address - Street 2:UNIT # 132
Mailing Address - City:PEARL HARBOR
Mailing Address - State:HI
Mailing Address - Zip Code:96860-4301
Mailing Address - Country:US
Mailing Address - Phone:808-352-6257
Mailing Address - Fax:
Practice Address - Street 1:1210 BATTLESHIP DR
Practice Address - Street 2:UNIT # 132
Practice Address - City:PEARL HARBOR
Practice Address - State:HI
Practice Address - Zip Code:96860-4301
Practice Address - Country:US
Practice Address - Phone:808-352-6257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman