Healthcare Provider Details

I. General information

NPI: 1710133970
Provider Name (Legal Business Name): LAWRENCE A. PABST, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 HOSFORD RD
GALION OH
44833-9325
US

IV. Provider business mailing address

PO BOX 704
GALION OH
44833-0704
US

V. Phone/Fax

Practice location:
  • Phone: 419-468-7059
  • Fax: 419-468-6962
Mailing address:
  • Phone: 419-467-7059
  • Fax: 419-468-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35038318
License Number StateOH

VIII. Authorized Official

Name: DR. LAWRENCE A PABST
Title or Position: PRESIDENT
Credential: M.D.
Phone: 419-468-7059