Larry Gideon, M D

NPI 1255533386 - Family Medicine - 207Q00000X

NPI Details
NPI 1255533386
Enumeration Date 06/01/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LARRY LARRY
Position PRESIDENT
Phone (810) 392-2192
Fax
Practice Location
609 BUNNELL M 19
MEMPHIS MI, 48041, US
Phone (810) 392-2192
Fax
Business Location
609 BUNNELL M 19
MEMPHIS MI, 48041, US
Phone (810) 392-2192
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Michigan
License Number LG407549
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According to our database, Larry Gideon, M D NPI is 1255533386, taxonomy code is 207Q00000X and license number is LG407549, license state is located at Michigan. Larry Gideon, M D physically located at 609 Bunnell M 19, Memphis MI, 48041. NPI Number 1033115704 has the healthcare provider type.

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1255533386 NPI number is provided on an as is basis without warranty of any kind. 1255533386 is maintained by the National Plan & Provider Enumeration System. The contents of Larry Gideon, M D are for informational purposes only.