Healthcare Provider Details

I. General information

NPI: 1033142021
Provider Name (Legal Business Name): JOSEPH J LACH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 27TH STREET, BRAUNLIN BLDG SUITE 306
PORTSMOUTH OH
45662-0000
US

IV. Provider business mailing address

1711 27TH STREET, BRAUNLIN BLDG SUITE 306
PORTSMOUTH OH
45662-0000
US

V. Phone/Fax

Practice location:
  • Phone: 740-353-8661
  • Fax: 740-354-3254
Mailing address:
  • Phone: 740-353-8661
  • Fax: 740-354-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.045109
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: