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
Show map & directions

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