Provider Demographics
NPI:1396851366
Name:CARLYON, LARRY FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:FRANCIS
Last Name:CARLYON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHILMAN LN
Mailing Address - Street 2:
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-9759
Mailing Address - Country:US
Mailing Address - Phone:906-485-1187
Mailing Address - Fax:
Practice Address - Street 1:770 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:LANSE
Practice Address - State:MI
Practice Address - Zip Code:49946-1126
Practice Address - Country:US
Practice Address - Phone:906-524-3435
Practice Address - Fax:906-524-5466
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI040361174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist