Provider Demographics
NPI:1124019385
Name:LOCHNER, JACOB L V (DO)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:L
Last Name:LOCHNER
Suffix:V
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1325 S CONGRESS AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5876
Mailing Address - Country:US
Mailing Address - Phone:561-659-5443
Mailing Address - Fax:561-659-4614
Practice Address - Street 1:300 ROYAL PALM WAY
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-4305
Practice Address - Country:US
Practice Address - Phone:561-659-5443
Practice Address - Fax:561-659-4614
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS7396208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252100800Medicaid
FL252100800Medicaid
G47027Medicare UPIN