Individual
MR. LARRY R NISHON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2158 COMMONS PKWY, OKEMOS, MI 48864-3986
(517) 349-6855
(517) 349-7158
Mailing address
2158 COMMONS PKWY, OKEMOS, MI 48864-3986
(517) 349-6855
(517) 349-7158
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
LN001085
MI
213ES0131X
Foot Surgery Podiatrist
Primary
LN001085
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710897
—
MI
01
—
2700008
PHP
MI
01
—
4814430001
DMERC
MI
01
—
4814430002
DMERC
MI
Enumeration date
07/18/2005
Last updated
09/11/2025
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