| E. A. Austin Do Pc | |
|
110 S Madison St Traverse City MI 49684-2340 | |
| (231) 946-0911 | |
| (231) 935-0343 |
| Full Name | E. A. Austin Do Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 110 S Madison St, Traverse City, Michigan |
| Authorized Official Name and Position | Cynthia Jean Conquest (PRACTICE MANAGER) |
| Authorized Official Contact | 2319350340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| E. A. Austin Do Pc 110 S Madison St Traverse City MI 49684-2340 Ph: (231) 946-0911 | E. A. Austin Do Pc 110 S Madison St Traverse City MI 49684-2340 Ph: (231) 946-0911 |
| NPI Number | 1003268202 |
|---|---|
| Provider Enumeration Date | 07/12/2016 |
| Last Update Date | 07/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003268202 | NPI | - | NPPES |
| 1477715076 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 5101017642 (Michigan) | Primary |
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