| Lighthouse Family Medicine, Pllc | |
|
4071 24th Ave Fort Gratiot MI 48059-3801 | |
| (810) 824-4222 | |
| (810) 824-4220 |
| Full Name | Lighthouse Family Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4071 24th Ave, Fort Gratiot, Michigan |
| Authorized Official Name and Position | G. Blair Dowden (MEDICAL DOCTOR) |
| Authorized Official Contact | 8108244222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Family Medicine, Pllc 4071 24th Ave Fort Gratiot MI 48059-3801 Ph: (810) 824-4222 | Lighthouse Family Medicine, Pllc 4071 24th Ave Fort Gratiot MI 48059-3801 Ph: (810) 824-4222 |
| NPI Number | 1114222031 |
|---|---|
| Provider Enumeration Date | 01/25/2011 |
| Last Update Date | 01/25/2011 |
| Medicare PECOS PAC ID | 4082890769 |
|---|---|
| Medicare Enrollment ID | O20110513000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114222031 | NPI | - | NPPES |
| 1750379194 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301088847 (Michigan) | Primary |
| Provider Name | Julie A Boutt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285749549 PECOS PAC ID: 8224003827 Enrollment ID: I20040827000544 |
| Provider Name | Linda M Esch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790738375 PECOS PAC ID: 7416983960 Enrollment ID: I20050715000286 |
| Provider Name | G Blair Dowden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750379194 PECOS PAC ID: 7810935632 Enrollment ID: I20060925000427 |
| Provider Name | Karen M Dowden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306985486 PECOS PAC ID: 1759471196 Enrollment ID: I20071221000233 |
| Provider Name | Joshua Allen Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568789980 PECOS PAC ID: 8527360890 Enrollment ID: I20160104000299 |
| Provider Name | Renee Ann Jankowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417311291 PECOS PAC ID: 7315239837 Enrollment ID: I20160701000964 |
| Provider Name | Josephine M Kamendat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801387592 PECOS PAC ID: 5092062547 Enrollment ID: I20180716001972 |
| Provider Name | Meagan Smoyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871072546 PECOS PAC ID: 8224387022 Enrollment ID: I20180827002582 |
| Provider Name | Alicia Mcnary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528606290 PECOS PAC ID: 7911334669 Enrollment ID: I20200219001623 |
| Provider Name | Charli Marie Souza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477193134 PECOS PAC ID: 3375972441 Enrollment ID: I20200413000197 |
B. Nakhleh, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059 Phone: 810-216-4000 Fax: 810-216-4001 | |
Randy J. Plonka M.d. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5979 Lakeshore Rd, Fort Gratiot, MI 48059 Phone: 810-385-6370 Fax: 810-385-6357 | |
Horizon Family Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3041 Commerce Dr Ste B, Fort Gratiot, MI 48059 Phone: 810-385-4342 | |
Port Huron Mercy Family Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059 Phone: 810-216-4000 Fax: 810-216-4001 | |
Sunrise Pace Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5229 Lakeshore Road, Fort Gratiot, MI 48059 Phone: 810-388-6300 Fax: 810-388-6305 | |
Lake Huron Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059 Phone: 810-216-4000 Fax: 810-216-4001 |