John R Loesch OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3184T545 Issued in OH

Legal business name

JOHN R LOESCH OD

Practice address

3721 N Main St
Dayton, OH 45405

Phone

(937) 278-5689

Fax

(937) 278-6781

NPI assigned

Apr 17, 2008

Organization subpart

Yes

Parent organization

JOHN R LOESCH ODAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John R Loesch, OD

Title

Owner

Phone

(937) 278-5689

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

John R Loesch OD

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1710151071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45405",
            "telephone_number": "937-278-5689",
            "fax_number": "937-278-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45405",
            "telephone_number": "937-278-5689",
            "fax_number": "937-278-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R LOESCH OD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN R LOESCH OD",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "LOESCH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-278-5689",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3184T545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332689",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Dayton, OH
• Providers in Dayton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.