Laurence Tan Co, M.D.

Individual provider Active NPI Psychiatry Physician · Caro, MI

NPI 1659484111 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1659484111
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
LC048810 (MI)
Practice address
2000 Chambers Road
Caro, MI 48723-9296
Phone
(989) 673-3191
Fax
(989) 673-0064
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LC048810MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Michigan Office of Financial Management Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LC048810 MI Yes

Addresses

Primary practice location

2000 Chambers Road
Caro, MI 48723-9296

Mailing address

2000 Chambers Road
Caro, MI 48723-9296
Phone (989) 673-3191

Other identifiers

IdentifierTypeStateIssuer
2607910952OtherMIBLUE CROSS BLUE SHIELD

Other providers in Caro, MI

All providers in Caro, MI · Psychiatry Physician in Michigan

Sources for this page

Verify at the official NPI Registry.