Healthcare Provider Details

I. General information

NPI: 1922033562
Provider Name (Legal Business Name): MEDICAL ONCOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 STABLER ST
LANSING MI
48910-3022
US

IV. Provider business mailing address

2901 STABLER ST
LANSING MI
48910-3022
US

V. Phone/Fax

Practice location:
  • Phone: 517-272-1950
  • Fax: 517-272-1961
Mailing address:
  • Phone: 517-272-1950
  • Fax: 517-272-1961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number5101008862
License Number StateMI

VIII. Authorized Official

Name: DR. BETH MARIE LAYHE
Title or Position: HEMATOLOGIST ONCOLOGIST
Credential: D.O.
Phone: 517-272-1950