Laetsch, Theodore Willis
Laetsch, Theodore Willis is an individual health care provider with primary practice located at 3401 Civic Center Blvd , Philadelphia PA 19104-4319. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Laetsch, Theodore Willis can be contacted via phone (267) 425-0126.Contact Information
Primary practice address
3401 Civic Center Blvd
Philadelphia PA 19104-4319
Phone: (267) 425-0126
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | P6853 | Texas |
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | MD436327 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD436327 | Pennsylvania |
Profile Details
| NPI number | 1154477834 |
|---|---|
| LBN Legal business name | Laetsch, Theodore Willis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2007 |
| Last updated | Feb 19th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154477834 | NPPES |
| Colorado | MEDICAID | 13339796 |
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