Organization
MCLAREN GREATER LANSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE THOMPSON (CFO)
(517) 975-7555
Entity
Organization
Contact information
Practice address
401 W GREENLAWN AVE STE 110, INGHAM REGIONAL MEDICAL CENTER, LANSING, MI 48910
(517) 334-2121
Mailing address
2111 UNIVERISTY PARK DR, STE 800, OKEMOS, MI 48864
(517) 908-0039
(517) 908-0038
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
064510
MI
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3375736
—
MI
05
—
4327359
—
MI
05
—
4363604
—
MI
05
—
4402874
—
MI
Enumeration date
09/13/2007
Last updated
08/02/2018
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