Healthcare Provider Details

I. General information

NPI: 1235250978
Provider Name (Legal Business Name): GERALD L GILROY DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 W LAKE LANSING RD SUITE 500 ASHER COURT
EAST LANSING MI
48823-8472
US

IV. Provider business mailing address

231 W LAKE LANSING RD SUITE 500 ASHER COURT
EAST LANSING MI
48823-8472
US

V. Phone/Fax

Practice location:
  • Phone: 517-324-3278
  • Fax: 517-324-3657
Mailing address:
  • Phone: 517-324-3278
  • Fax: 517-324-3657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number5101006179
License Number StateMI

VIII. Authorized Official

Name: GERALD L GILROY
Title or Position: OWNER
Credential: D.O.
Phone: 517-324-3278