Provider Demographics
NPI:1023202454
Name:LANSING FAMILY PHYSICIANS PC
Entity Type:Organization
Organization Name:LANSING FAMILY PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MORTON
Authorized Official - Last Name:EGGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-484-4520
Mailing Address - Street 1:4202 COLLINS RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-5894
Mailing Address - Country:US
Mailing Address - Phone:517-484-4520
Mailing Address - Fax:517-484-3930
Practice Address - Street 1:4202 COLLINS RD
Practice Address - Street 2:SUITE 115
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-5894
Practice Address - Country:US
Practice Address - Phone:517-484-4520
Practice Address - Fax:517-484-3930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301042365208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0331223OtherBCN
MI0803312231OtherBCBSM
MI0331223OtherBCN
MIB44835Medicare UPIN