Healthcare Provider Details

I. General information

NPI: 1609681923
Provider Name (Legal Business Name): LAPEER COUNTY JAIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 JOHN CONLEY DR.
LAPEER MI
48446
US

IV. Provider business mailing address

3231 JOHN CONLEY DR.
LAPEER MI
48446
US

V. Phone/Fax

Practice location:
  • Phone: 810-664-1801
  • Fax:
Mailing address:
  • Phone: 810-664-1801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT ROBERT MCKENNA
Title or Position: SHERIFF
Credential:
Phone: 810-245-1325