Provider Demographics
NPI:1538229513
Name:LAUB, RONALD (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:LAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 N CIRCLE DR
Mailing Address - Street 2:STE 210
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1180
Mailing Address - Country:US
Mailing Address - Phone:719-228-9440
Mailing Address - Fax:
Practice Address - Street 1:3010 N CIRCLE DR
Practice Address - Street 2:# 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1182
Practice Address - Country:US
Practice Address - Phone:719-228-9440
Practice Address - Fax:719-228-9061
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23261207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COIN650257OtherBC-BS INDIVIDUAL
CO46733272Medicaid
COC473508OtherMEDICARE - GROUP
COLA646340OtherBC-BS-GROUP
CO46733272Medicaid
COIN650257OtherBC-BS INDIVIDUAL