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General NPI Number Information
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NPI Number | 1972878452
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Entity Type | Organization
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Legal Business Name | MCLAREN GREATER LANSING
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 2270 JOLLY OAK RD STE 1
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City | OKEMOS
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State | MI
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Zip | 48864-6932
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Country | US
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Telephone | 517-975-9475
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Fax |
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Provider Business Mailing Address
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Address Line | 2270 JOLLY OAK RD STE 1
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City | OKEMOS
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State | MI
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Zip | 48864-6932
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Country | US
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Telephone | 517-975-9475
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. DALE THOMPSON
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Credential |
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Telephone | 517-975-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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