1457354235 NPI number — DR. ROBERT B LORSBACH MD PHD

Table of content: DR. ROBERT B LORSBACH MD PHD (NPI 1457354235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457354235 NPI number — DR. ROBERT B LORSBACH MD PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LORSBACH
Provider First Name:
ROBERT
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457354235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 636256 CENTRAL CREDENTIALING
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-6256
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-585-5507
Provider Business Mailing Address Fax Number:
513-585-5511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3333 BURNET AVE
Provider Second Line Business Practice Location Address:
ML 1010
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45229-3026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-636-4261
Provider Business Practice Location Address Fax Number:
513-636-3026
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZH0000X , with the licence number:  E4998 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZH0000X , with the licence number: 31249 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , with the licence number: 35.124563 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200377080A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 205094105 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00120394 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0149549 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100200820A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 136341001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 542870 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7613558 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0030961 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3838303 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00370752 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 009914400 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0527689 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1429732 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200224770A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64721988 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104783064 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 422400000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 536148329A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com