Healthcare Provider Details

I. General information

NPI: 1962469189
Provider Name (Legal Business Name): CARDIOLOGY GROUP OF LANSING P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 SPRING ARBOR RD STE 100
JACKSON MI
49203-3652
US

IV. Provider business mailing address

5894 MARENGO ST
JACKSON MI
49201-8315
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-7844
  • Fax: 517-783-5044
Mailing address:
  • Phone: 517-745-3403
  • Fax: 517-482-3664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: HARESH JANI
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 517-482-2020