Provider Demographics
NPI:1902073109
Name:WILLOUGHBY, LAURA ANNE GELLHAUS (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANNE GELLHAUS
Last Name:WILLOUGHBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:ANNE
Other - Last Name:GELLHAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2230 WILEY BLVD SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-2364
Mailing Address - Country:US
Mailing Address - Phone:319-369-4340
Mailing Address - Fax:319-369-4341
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-1052
Practice Address - Fax:612-467-3783
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine