Provider Demographics
NPI:1427696400
Name:HESS, LORI KAYE (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:KAYE
Last Name:HESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1387 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3648
Mailing Address - Country:US
Mailing Address - Phone:513-939-7982
Mailing Address - Fax:
Practice Address - Street 1:1387 PIERCE ST
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3648
Practice Address - Country:US
Practice Address - Phone:513-939-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056135207Q00000X
MI4301104538207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine