| Lansing Osteopathic Medical Group Pc | |
|
4655 Dobie Rd Suite 260 Okemos MI 48864-2233 | |
| (517) 482-1183 | |
| (517) 482-9877 |
| Full Name | Lansing Osteopathic Medical Group Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4655 Dobie Rd, Okemos, Michigan |
| Authorized Official Name and Position | Jerry J Chandler (PHYSICIAN) |
| Authorized Official Contact | 5174821183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lansing Osteopathic Medical Group Pc 4655 Dobie Rd Suite 260 Okemos MI 48864-2233 Ph: (517) 482-1183 | Lansing Osteopathic Medical Group Pc 4655 Dobie Rd Suite 260 Okemos MI 48864-2233 Ph: (517) 482-1183 |
| NPI Number | 1750530721 |
|---|---|
| Provider Enumeration Date | 09/15/2008 |
| Last Update Date | 09/15/2008 |
| Medicare PECOS PAC ID | 5597832170 |
|---|---|
| Medicare Enrollment ID | O20080923000838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750530721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101006090 (Michigan) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 5101006090 (Michigan) | Primary |
| Provider Name | Jerry J Chandler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376629287 PECOS PAC ID: 5597668483 Enrollment ID: I20040128001121 |
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