Provider Demographics
NPI:1285959445
Name:BLOCKER, LAURA GAMBINI (MD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:GAMBINI
Last Name:BLOCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:605 W MAIN STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611
Mailing Address - Country:US
Mailing Address - Phone:970-925-8005
Mailing Address - Fax:970-920-1652
Practice Address - Street 1:605 W MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611
Practice Address - Country:US
Practice Address - Phone:970-925-8005
Practice Address - Fax:970-920-1652
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40724207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology