Provider Demographics
NPI:1134543739
Name:BARBARA D SAXENA MD PLLC
Entity type:Organization
Organization Name:BARBARA D SAXENA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:DARLING
Authorized Official - Last Name:SAXENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-622-1775
Mailing Address - Street 1:PO BOX 80227
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48908-0227
Mailing Address - Country:US
Mailing Address - Phone:517-622-1775
Mailing Address - Fax:517-913-6078
Practice Address - Street 1:1005 CHARLEVOIX DR
Practice Address - Street 2:SUITE 180
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-2432
Practice Address - Country:US
Practice Address - Phone:517-622-1775
Practice Address - Fax:517-913-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBS060808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4086317Medicaid