Healthcare Provider Details

I. General information

NPI: 1144150103
Provider Name (Legal Business Name): DONALD LAUTNER III
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 E BELLOWS ST
MOUNT PLEASANT MI
48858-3940
US

IV. Provider business mailing address

906 E BELLOWS ST
MOUNT PLEASANT MI
48858-3940
US

V. Phone/Fax

Practice location:
  • Phone: 231-535-2822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: