Marshall R. Wickens Do, Pc | |
207 S Chestnut St Unit B Reed City MI 49677-1205 | |
(231) 832-9488 | |
(231) 832-9348 |
Full Name | Marshall R. Wickens Do, Pc |
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Speciality | Family Medicine |
Location | 207 S Chestnut St Unit B, Reed City, Michigan |
Authorized Official Name and Position | Marshall Robert Wickens (OWNER) |
Authorized Official Contact | 2318329488 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Marshall R. Wickens Do, Pc 207 S Chestnut St Unit B Reed City MI 49677-1205 Ph: (231) 832-9488 | Marshall R. Wickens Do, Pc 207 S Chestnut St Unit B Reed City MI 49677-1205 Ph: (231) 832-9488 |
NPI Number | 1043616378 |
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Provider Enumeration Date | 11/13/2014 |
Last Update Date | 11/13/2014 |
Medicare PECOS PAC ID | 6507189776 |
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Medicare Enrollment ID | O20141218001553 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043616378 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5101011160 (Michigan) | Primary |
Provider Name | Marshall R Wickens |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1841263134 PECOS PAC ID: 3678467297 Enrollment ID: I20040212000669 |
Samaritan Health Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4361 220th Ave, Reed City, MI 49677 Phone: 616-225-0202 Fax: 616-225-0207 | |