Provider Demographics
NPI:1710133970
Name:LAWRENCE A. PABST, M.D., INC.
Entity Type:Organization
Organization Name:LAWRENCE A. PABST, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PABST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-468-7059
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-0704
Mailing Address - Country:US
Mailing Address - Phone:419-467-7059
Mailing Address - Fax:419-468-6962
Practice Address - Street 1:955 HOSFORD RD
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-9325
Practice Address - Country:US
Practice Address - Phone:419-468-7059
Practice Address - Fax:419-468-6962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35038318207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0398878Medicaid
OH0463522Medicare PIN
OHA78771Medicare UPIN