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NPI Code Detail

MEDICARE: JOHN LAURAIN M.D.

MEDICARE: JOHN LAURAIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianJL053504IN

General Provider Information

NPI Number : 1053410704
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN LAURAIN M.D.
Provider Business Mailing Address
First Line : 2016 NORTHAMPTON WAY
Second Line :
City : LANSING
State : MI
Zip : 48912-3528
Country : US
Telephone Number : 517-244-9170
Fax Number : 517-244-9173
Provider Business Practice Location Address
First Line : 6620 PARKDALE PL STE D
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-4697
Country : US
Telephone Number : 317-415-7373
Fax Number : 317-415-7310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 11/13/2025

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