Provider Demographics
NPI:1215117536
Name:AMELIA E LAING M.D. LTD
Entity type:Organization
Organization Name:AMELIA E LAING M.D. LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAING
Authorized Official - Suffix:
Authorized Official - Credentials:MD LTD
Authorized Official - Phone:330-765-9104
Mailing Address - Street 1:830 S MAIN ST
Mailing Address - Street 2:STE 102
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-2291
Mailing Address - Country:US
Mailing Address - Phone:330-765-9104
Mailing Address - Fax:330-682-0747
Practice Address - Street 1:830 S MAIN ST
Practice Address - Street 2:STE 102
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-2291
Practice Address - Country:US
Practice Address - Phone:330-765-9104
Practice Address - Fax:330-682-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHBL5415547207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2172483Medicaid
OHSP02351Medicare PIN
OHSP02352Medicare PIN