Individual
TIMOTHY J LACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 275-1200
(812) 275-1231
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01047300A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100267990
—
IN
05
—
200195550
—
IN
Enumeration date
09/20/2006
Last updated
02/24/2023
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