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General NPI Number Information
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NPI Number | 1932297827
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Entity Type | Organization
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Legal Business Name | PODIATRY PLUS PC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 912 CENTENNIAL WAY SUITE 380
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City | LANSING
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State | MI
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Zip | 48917-8246
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Country | US
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Telephone | 517-321-9303
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Fax | 517-321-1730
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Provider Business Mailing Address
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Address Line | 912 CENTENNIAL WAY SUITE 380
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City | LANSING
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State | MI
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Zip | 48917-8246
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Country | US
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Telephone | 517-321-3668
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Fax | 517-321-1730
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAY OWEN MEYER
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Credential | DPM
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Telephone | 517-349-6855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | LN001085
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | JM001350
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License Number State | MI
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