Provider Demographics
NPI:1033142021
Name:LACH, JOSEPH J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:LACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 27TH STREET, BRAUNLIN BLDG
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-0000
Mailing Address - Country:US
Mailing Address - Phone:740-353-8661
Mailing Address - Fax:740-354-3254
Practice Address - Street 1:1711 27TH STREET, BRAUNLIN BLDG
Practice Address - Street 2:SUITE 306
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-0000
Practice Address - Country:US
Practice Address - Phone:740-353-8661
Practice Address - Fax:740-354-3254
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.045109208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2596678Medicaid
OHLA7336501Medicare ID - Type Unspecified
OHC25229Medicare UPIN