Provider Demographics
NPI:1831381110
Name:PEARCH, JEFFREY THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:THOMAS
Last Name:PEARCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 E MAIN ST
Mailing Address - Street 2:PO BOX 2563
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4056
Mailing Address - Country:US
Mailing Address - Phone:740-687-8990
Mailing Address - Fax:740-687-8230
Practice Address - Street 1:131 N EWING ST
Practice Address - Street 2:UNIT C
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3383
Practice Address - Country:US
Practice Address - Phone:740-689-6600
Practice Address - Fax:740-689-6603
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0089842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2854853Medicaid
OH2854853Medicaid