Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 01055597A | IN |
N | 207W00000X | Ophthalmologist | 01055597A | IN |
NPI | 1194719757 |
---|---|
Provider Name | Lawrence Hastings Schoch |
First Address | Madison, IN 47250-2912 |
Second Address | Madison, IN 47250-2491 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 12/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200379700 | (05) | IN |
A28684 | (02) | IN |