Larry Gideon, M D | |
609 Bunnell M 19 Memphis MI 48041 | |
(810) 392-2192 | |
Not Available |
Full Name | Larry Gideon, M D |
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Speciality | Family Medicine |
Location | 609 Bunnell M 19, Memphis, Michigan |
Authorized Official Name and Position | Larry Gideon (PRESIDENT) |
Authorized Official Contact | 8103922192 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Larry Gideon, M D 609 Bunnell M 19 Memphis MI 48041 Ph: (810) 392-2192 | Larry Gideon, M D 609 Bunnell M 19 Memphis MI 48041 Ph: (810) 392-2192 |
NPI Number | 1255533386 |
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Provider Enumeration Date | 06/01/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255533386 | NPI | - | NPPES |
LG407549 | Other | MI | STATE LICENCE |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | LG407549 (Michigan) | Primary |