Provider Demographics
NPI:1093843880
Name:LAUBACH, JOHN BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRUCE
Last Name:LAUBACH
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 1:9139 RANCH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5078
Mailing Address - Country:US
Mailing Address - Phone:303-814-1851
Mailing Address - Fax:
Practice Address - Street 1:9139 RANCH RIVER RD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5078
Practice Address - Country:US
Practice Address - Phone:303-814-1851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17119207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO17119OtherMEDICAL LICENSE
B24247Medicare UPIN
CO17119OtherMEDICAL LICENSE