| Doctor Name: | DR. LAURENCE WILLIAM VALE DEBOER |
| NPI Number: | 1043315872 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | E0878 |
| Business Practice Address: | 430 Medical Arts Ct. Gillette, WY - 82716 |
| Business Phone Number: | 3076827661 |
| Business Fax Number: | 3076827624 |
| Mailing Address: | 430 Medical Arts Ct., GILLETTE |
| State: | WY |
| Postal Code: | 82716 |
| Phone Number: | 3076827661 |
| Fax Number: | 3076827624 |
| NPI Enumeration Date: | 09/14/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | E0878 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |