Provider Demographics
NPI:1649244971
Name:LAUB, JAMES LEIGH (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEIGH
Last Name:LAUB
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2510 COMMONS BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3820
Mailing Address - Country:US
Mailing Address - Phone:937-429-8620
Mailing Address - Fax:937-429-8629
Practice Address - Street 1:2510 COMMONS BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3820
Practice Address - Country:US
Practice Address - Phone:937-429-8620
Practice Address - Fax:937-429-8629
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-08-22
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Provider Licenses
StateLicense IDTaxonomies
OH34008358204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2532923Medicaid
OHLA4145721Medicare Oscar/Certification
OHI20275Medicare UPIN