Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth James Tack, MD

Individual provider Infectious Disease Physician · NPI 1932985850

Kenneth James Tack, MD is an Infectious Disease Physician in South Lyon, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

10366 Stoney Point Dr
South Lyon, MI 48178-8053
Phone: (810) 355-8281
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X · Licence 4301043465 (MI)

Record details

NPI number1932985850
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 6, 2023
Last updated in NPPESSeptember 6, 2023
Certification dateSeptember 6, 2023
Mailing address10366 Stoney Point Dr, South Lyon, MI 48178-8053