Most Relevant Information
Provider Data
| NPI Number: | 1003201880 |
| Provider Name: | JOHANNA LAIDIG D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 207L00000X |
| Specialty: | Anesthesiology |
| License Number: | 05308 |
Most Important Dates
| Enumeration Date: | 03/30/2015 |
| Last Updated: | 05/13/2021 |
Provider Practice Location
1227 E RUSHOLME ST
DAVENPORT
IA
528032459
Practice Location Phone/Fax
| Phone: | 5634211000 |
| Fax: |
Provider Mailing Location
PO BOX 1245
BETTENDORF
IA
527220021
Provider Mailing Phone/Fax
| Phone: | 5633248160 |
| Fax: | 5633248486 |