Basic Information
| Provider Information | |||||||||
| NPI: | 1902923733 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RASANSKY | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JORDAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8950 TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | TAYLOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481808399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3132953937 | ||||||||
| FaxNumber: | 3132952006 | ||||||||
| Practice Location | |||||||||
| Address1: | 8950 TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | TAYLOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481808399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3132953937 | ||||||||
| FaxNumber: | 3132952006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2007 | ||||||||
| LastUpdateDate: | 01/01/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 5101016980 | MI | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.