Provider Demographics
NPI:1124089800
Name:RASOR, JOHN B (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:RASOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE HOWELL
Practice Address - Street 2:202 W HIGHLAND RD
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843
Practice Address - Country:US
Practice Address - Phone:517-234-6540
Practice Address - Fax:517-338-9083
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009380207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI030525737OtherTAX ID
MI3185184Medicaid
MIE78156Medicare UPIN
MI0N84630Medicare ID - Type Unspecified