East Lansing Orthopedic Association P C

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

EAST LANSING ORTHOPEDIC ASSOCIATION P C

Practice address

3394 E Jolly Rd
Ste a
Lansing, MI 48910-8595

Phone

(517) 394-3200

Fax

(517) 394-4250

NPI assigned

Jun 27, 2005

Organization subpart

No

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

Authorized official

Name

Dr. David A Detrisac, MD

Title

President

Phone

(517) 394-3200

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544659200000",
    "number": "1366448037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3394 E JOLLY RD",
            "address_2": "STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489108595",
            "telephone_number": "517-394-3200",
            "fax_number": "517-394-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3394 E JOLLY RD",
            "address_2": "STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489108595",
            "telephone_number": "517-394-3200",
            "fax_number": "517-394-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LANSING ORTHOPEDIC ASSOCIATION P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2018-12-13",
        "status": "A",
        "authorized_official_last_name": "DETRISAC",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-394-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCN",
            "identifier": "G04755",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BC/BS",
            "identifier": "20-0C3-1063-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parthasarathy Eappakkam Kumaraswamy, DSCPT, OCS, FAAOMPT
• Jessica Earl, LLBSW
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• Trisha Lee Easley, LPC
• East Lansing Dental PLLC
• East Michigan Family Care PLC
• Talitha P Easterly, PH.D
• Eastside Community Action Center
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• Brenda Surae Eaton, MD

• Orthopaedic Surgery Physician in Lansing, MI
• Providers in Lansing, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.