Individual
JOSEPH R. LACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 W STATE ROUTE 89A, SEDONA, AZ 86336-4937
(928) 204-4944
Mailing address
1200 N BEAVER ST, ATTN: PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-05-3812
OH
207R00000X
Internal Medicine Physician
Primary
60069
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0724658
—
OH
Enumeration date
07/01/2006
Last updated
12/22/2022
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