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General NPI Number Information
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NPI Number | 1861422545
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Entity Type | Organization
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Legal Business Name | MEDLEY A LARKIN D O P C
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 4680 MCLEOD DR E
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City | SAGINAW
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State | MI
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Zip | 48604-2852
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Country | US
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Telephone | 989-791-9133
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Fax |
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Provider Business Mailing Address
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Address Line | 4449 FASHION SQUARE BLVD
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City | SAGINAW
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State | MI
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Zip | 48603-5217
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Country | US
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Telephone | 989-790-0007
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Fax | 989-790-7441
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Authorized Official
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Title or Position | OWNER
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Name | MEDLEY A LARKIN
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Credential | D.O.
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Telephone | 989-791-9133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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