Larry L Pack MD PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

4301035400 Issued in MI

Legal business name

LARRY L PACK MD PC

Practice address

2420 Owen Rd
Ste C
Fenton, MI 48430-3417

Phone

(810) 750-5800

Fax

(810) 750-5809

NPI assigned

Oct 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Larry L Pack, M.D.NPI 1477534774

Title

Owner

Phone

(810) 750-5800

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry L. Pack, MD

  • Orthopaedic Surgery Physician
  • Fenton, MI
  • NPI 1477534774
  NPD (past) Authorized official

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1780767145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9362 WARWICK MDWS",
            "address_2": "PO BOX 590",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484399552",
            "telephone_number": "810-750-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 OWEN RD",
            "address_2": "STE C",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303417",
            "telephone_number": "810-750-5800",
            "fax_number": "810-750-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY L PACK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-21",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-750-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301035400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4940460",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kurtis Lahring, LMSW-C
• Lake Fenton Haus Inc
• Ashley Louise Lamb, FNP-C
• Elyse Lamphier
• Kimberly Kay Lange, FNP-BC
• Laurie Denise Lawlor-Clark, CPS, MSW
• Lauren Ann Lay, MA, TLLP
• Cristina I Leclair, PSY D LP
• Patricia Ann Lee
• Alyson Marie Lenz

• Orthopaedic Surgery Physician in Fenton, MI
• Providers in Fenton, 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 Apr 15, 2010; 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.