Healthcare Provider Details
I. General information
NPI: 1164404356
Provider Name (Legal Business Name): JOHN JONES LIM YAP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/15/2005
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
307 S COURT ST
LAPEER MI
48446-2514
US
IV. Provider business mailing address
4466 W BRISTOL RD
FLINT MI
48507-3170
US
V. Phone/Fax
- Phone: 810-667-6110
- Fax: 810-667-3562
- Phone: 810-733-1200
- Fax: 810-733-0688
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 4301059287 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | 4301059287 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: