| Larry Gideon, M D | |
|
609 Bunnell M 19 Memphis MI 48041 | |
| (810) 392-2192 | |
| Not Available |
| Full Name | Larry Gideon, M D |
|---|---|
| Speciality | Family Medicine |
| Location | 609 Bunnell M 19, Memphis, Michigan |
| Authorized Official Name and Position | Larry Gideon (PRESIDENT) |
| Authorized Official Contact | 8103922192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry Gideon, M D 609 Bunnell M 19 Memphis MI 48041 Ph: (810) 392-2192 | Larry Gideon, M D 609 Bunnell M 19 Memphis MI 48041 Ph: (810) 392-2192 |
| NPI Number | 1255533386 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255533386 | NPI | - | NPPES |
| LG407549 | Other | MI | STATE LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | LG407549 (Michigan) | Primary |