Southfield Lathrup Obstetrics and Gynecology PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

SOUTHFIELD LATHRUP OBSTETRICS AND GYNECOLOGY PC

Practice address

20276 Middlebelt Rd
Suite 2
Livonia, MI 48152-2054

Phone

(248) 476-4900

Fax

(248) 476-5435

NPI assigned

Jan 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ronald Zack, M.D.

Title

President

Phone

(248) 476-4900

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1033268263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20276 MIDDLEBELT RD",
            "address_2": "SUITE 2",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522054",
            "telephone_number": "248-476-4900",
            "fax_number": "248-476-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20276 MIDDLEBELT RD",
            "address_2": "SUITE 2",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522054",
            "telephone_number": "248-476-4900",
            "fax_number": "248-476-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD LATHRUP OBSTETRICS AND GYNECOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "ZACK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-476-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F37177",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.