Provider Demographics
NPI:1548239759
Name:LACROIX, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:LACROIX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1312
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-5312
Mailing Address - Country:US
Mailing Address - Phone:513-934-0900
Mailing Address - Fax:513-934-3732
Practice Address - Street 1:110 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1728
Practice Address - Country:US
Practice Address - Phone:513-934-0900
Practice Address - Fax:513-934-3732
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-077363207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00145994OtherRR MEDICARE
OH2238920Medicaid
OHP00145994OtherRR MEDICARE
OHH36070Medicare UPIN