| |
829 W Main St Ste G Gaylord MI 49735-1998 | |
(231) 545-4140 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 829 W Main St Ste G, Gaylord, Michigan |
Authorized Official Name and Position | Sandra Durant (CREDENTIALING) |
Authorized Official Contact | 2319201100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2329 Center St Ste 1 Boyne Falls MI 49713-9268 Ph: (231) 758-4566 | 829 W Main St Ste G Gaylord MI 49735-1998 Ph: (231) 545-4140 |
NPI Number | 1609427541 |
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Provider Enumeration Date | 09/23/2019 |
Last Update Date | 08/24/2022 |
Medicare PECOS PAC ID | 4284069063 |
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Medicare Enrollment ID | O20200124001902 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609427541 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Nichol L Tufts |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144579798 PECOS PAC ID: 7719204122 Enrollment ID: I20150324001526 |
Provider Name | Jean Christiana Marion Talsma |
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Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1144660200 PECOS PAC ID: 0840583639 Enrollment ID: I20160802000442 |
Provider Name | Kellie Herringa |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013387000 PECOS PAC ID: 5496038101 Enrollment ID: I20170203000092 |
Provider Name | Janine Roper |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356898159 PECOS PAC ID: 9234568494 Enrollment ID: I20200409001045 |
Pine Trees Medical Office, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 W Main St, Ste B, Gaylord, MI 49735 Phone: 989-448-2900 | |
Alpine Family Medicine Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 652 N Otsego Ave, Gaylord, MI 49735 Phone: 989-732-3529 Fax: 989-732-7865 | |
Otsego Physician Services Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 825 N Center Ave, Gaylord, MI 49735 Phone: 989-731-2100 Fax: 989-731-2205 | |
Donald P. Cousineau Do Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 994 N Center Ave, Gaylord, MI 49735 Phone: 989-732-7843 Fax: 989-731-4513 | |