MEDICARE: GREATER LANSING SURGICAL ASSOCIATES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	5101008020	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1649290156	OTHER		NPI

General Provider Information

NPI Number	:	1649290156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER LANSING SURGICAL ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 635369
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-5369
Country	:	US
Telephone Number	:	517-336-5176
Fax Number	:	517-336-5475

Provider Business Practice Location Address
First Line	:	221 W LAKE LANSING RD
Second Line	:	SUITE 300
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8661
Country	:	US
Telephone Number	:	517-351-0001
Fax Number	:	517-332-1816

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAN L HUNT
Credential	:	D.O.
Telephone Number	:	517-351-0001

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	08/07/2012

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