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General NPI Number Information
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NPI Number | 1366636755
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Entity Type | Organization
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Legal Business Name | LONSON L BARR, D.O., P.C.
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 1945 BOSTON ST SE STE 303
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-4100
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Country | US
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Telephone | 616-246-6262
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Fax | 616-246-8737
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Provider Business Mailing Address
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Address Line | 1945 BOSTON ST SE STE 303
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-4100
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Country | US
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Telephone | 616-246-6262
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Fax | 616-246-8737
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Authorized Official
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Title or Position | PRESIDENT & PHYSICIAN
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Name | DR. LONSON L BARR
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Credential | D.O.
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Telephone | 616-246-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5101005711
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License Number State | MI
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