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1711 S Stephenson Ave Ste 210 Iron Mountain MI 49801-3649 | |
(906) 776-5800 | |
(906) 776-5801 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1711 S Stephenson Ave Ste 210, Iron Mountain, Michigan |
Authorized Official Name and Position | Kathleen Bressler (COO, AO) |
Authorized Official Contact | 7159756018 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1000 N Oak Ave Attn: Provider Enrollment Coordinator Shp Fl 2 Marshfield WI 54449-5703 Ph: (715) 389-0660 | 1711 S Stephenson Ave Ste 210 Iron Mountain MI 49801-3649 Ph: (906) 776-5800 |
NPI Number | 1083659502 |
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Provider Enumeration Date | 06/18/2006 |
Last Update Date | 09/11/2024 |
Medicare PECOS PAC ID | 6800784943 |
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Medicare Enrollment ID | O20101020000306 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083659502 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Indigo Hospital Medicine - Iron Mountain Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1721 S Stephenson Ave, Iron Mountain, MI 49801 Phone: 906-776-5415 Fax: 906-776-5402 | |