Physician Compare National (NPI:1124197868)

HEALTHCARE PROVIDER: DENNIS R LAUB O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1124197868
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244354454
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100825000191
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LAUB
	Individual professional last name
Provider First Name	DENNIS
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	107 WALNUT ST
	Group Practice or individual's line 1 address
City	WOODVILLE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	434691333
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4198493811
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y