Provider Demographics
NPI:1548214992
Name:LOSCH, ANN G (DO)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:G
Last Name:LOSCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3839
Mailing Address - Country:US
Mailing Address - Phone:859-626-7700
Mailing Address - Fax:859-626-7890
Practice Address - Street 1:104 LEGACY DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-9594
Practice Address - Country:US
Practice Address - Phone:859-986-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04661207Q00000X
OH34-00-6846207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080139578OtherRR MEDICARE
OH2118345Medicaid
001714110OtherMOUNTAIN STATE BCBS
OH310917085101OtherCARESOURCE MEDICAID
WV5630053000Medicaid
WV5630053000Medicaid
001714110OtherMOUNTAIN STATE BCBS
080139578OtherRR MEDICARE
WV0885662Medicare PIN
OH2118345Medicaid
OH000000181970OtherUNISON MEDICAID