Dr. Laura Hazeltine , MD

Physician • Van Lear, KY

Deactivated NPI 1164553343 Deactivated in NPPES Female Practitioner

Practice location in NPPES

115 Wallen Dr
Van Lear, KY 412659045

Phone: 6067937953

Location details and other listings

Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of December 19, 2024; the reason is not published. The records below are historical. They do not show whether Dr. Laura Hazeltine currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date March 08, 2007

NPI Deactivation Date December 19, 2024

NPI Active Period 2007 – 2024

Practice Location & Contact Primary Location

Practice Address

115 Wallen Dr

Van Lear, KY 412659045

Telephone 6067937953

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Organization at the Same NPPES Address or Phone

Prestonsburg Health Center, Inc. Facility NPI 1053646745

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

What Public CMS Data Show

These CMS figures cover limited populations and published records; they are not quality ratings or medical advice.

Physician: NPPES taxonomy is a reported classification, not proof of board certification.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Van Lear and Kentucky

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Clinic/Center - Primary Care Primary Specialty

NUCC Taxonomy Code: 261QP2300X

License # reported to NPPES KY 25775

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Kentucky Board of Medical Licensure.

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Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events

⚠️

NPI Profile Deactivated December 19, 2024

NPPES lists this NPI as deactivated as of December 19, 2024; the reason is not published.

✅

NPI Profile Active June 01, 2009

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) June 01, 2009

Registered at 115 WALLEN DR, VAN LEAR, KY 412659045 (Tel: 6067937953)

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Business Mailing Address (Initial Record) June 01, 2009

Registered at 115 WALLEN DR, VAN LEAR, KY 412659045 (Tel: 6067937953)

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Provider Name / Credentials (Initial Record) June 01, 2009

Recorded as LAURA HAZELTINE, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 01, 2009

Clinic/Center (license number reported to NPPES: KY 25775)

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Initial NPI Registration & Enumeration March 08, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1164553343

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 08, 2007

Last Update: June 01, 2009

Deactivation Date: December 19, 2024

Update or Correct Profile

Mailing Address

115 Wallen Dr

Van Lear, KY 412659045

Phone: 6067937953

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.