| Bronson Vicksburg Emergency Physicians | |
|
13326 N Boulevard St Vicksburg MI 49097-1514 | |
| (269) 649-2321 | |
| Not Available |
| Full Name | Bronson Vicksburg Emergency Physicians |
|---|---|
| Speciality | Emergency Medicine |
| Location | 13326 N Boulevard St, Vicksburg, Michigan |
| Authorized Official Name and Position | Denise M Bartz (CONTRACT CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2693417806 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bronson Vicksburg Emergency Physicians 601 John St Box 42 Kalamazoo MI 49007-5341 Ph: (269) 341-7806 | Bronson Vicksburg Emergency Physicians 13326 N Boulevard St Vicksburg MI 49097-1514 Ph: (269) 649-2321 |
| NPI Number | 1770597494 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 12/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770597494 | NPI | - | NPPES |
| C20578 | Other | MI | RAILROAD MEDICARE |
| 0C96065 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | (* (Not Available)) | Primary |
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