Healthcare Provider Details

I. General information

NPI: 1154252393
Provider Name (Legal Business Name): RONALD LEE VIGES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4902 S CEDAR ST
LANSING MI
48910-5474
US

IV. Provider business mailing address

6667 BUNKER HILL DR
LANSING MI
48906-9135
US

V. Phone/Fax

Practice location:
  • Phone: 517-394-7867
  • Fax: 517-394-7869
Mailing address:
  • Phone: 517-394-7867
  • Fax: 517-394-7869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: