Provider Demographics
NPI:1053490664
Name:LAUX, KENNETH JAMES JR (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:JAMES
Last Name:LAUX
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 118
Mailing Address - Street 2:420 LANCASTER PIKE
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113
Mailing Address - Country:US
Mailing Address - Phone:740-477-3333
Mailing Address - Fax:740-477-1100
Practice Address - Street 1:420 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-9272
Practice Address - Country:US
Practice Address - Phone:740-477-3333
Practice Address - Fax:740-477-1100
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0992458Medicaid
OH000000120411OtherANTHEM BC BS PROV ID
OHU47747Medicare UPIN
OH000000120411OtherANTHEM BC BS PROV ID