Provider Demographics
NPI:1801069976
Name:PAULUS, LAURA RENEA (OD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:RENEA
Last Name:PAULUS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:RENEA
Other - Last Name:STORM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:15840 MEDICAL DR S
Mailing Address - Street 2:SUITE A
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-7833
Mailing Address - Country:US
Mailing Address - Phone:419-422-6190
Mailing Address - Fax:419-423-3235
Practice Address - Street 1:15840 MEDICAL DR S
Practice Address - Street 2:SUITE A
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-7833
Practice Address - Country:US
Practice Address - Phone:419-422-6190
Practice Address - Fax:419-423-3235
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5773T2687152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0090517Medicaid
OHH188301Medicare PIN
FLAS753ZMedicare PIN
GA394392655AMedicaid
FLP00857233Medicare PIN