Provider Demographics
NPI:1043542202
Name:LORNA G. PINSON, MD PLLC
Entity Type:Organization
Organization Name:LORNA G. PINSON, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DESY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-782-2540
Mailing Address - Street 1:744 W. MICHIGAN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201
Mailing Address - Country:US
Mailing Address - Phone:517-782-2540
Mailing Address - Fax:517-782-1560
Practice Address - Street 1:744 W MICHIGAN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1900
Practice Address - Country:US
Practice Address - Phone:517-782-2540
Practice Address - Fax:517-782-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI053446261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care