Spring Street Family Practice | |
1207 N Spring St Gladwin MI 48624 | |
(989) 426-5553 | |
Not Available |
Full Name | Spring Street Family Practice |
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Speciality | Family Medicine |
Location | 1207 N Spring St, Gladwin, Michigan |
Authorized Official Name and Position | Janet Flynn (OWNER) |
Authorized Official Contact | 9894265590 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Spring Street Family Practice 801 Joe Mann Blvd Ste P-6 Midland MI 48642-8900 Ph: (989) 791-2455 | Spring Street Family Practice 1207 N Spring St Gladwin MI 48624 Ph: (989) 426-5553 |
NPI Number | 1083790026 |
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Provider Enumeration Date | 10/31/2006 |
Last Update Date | 08/23/2022 |
Medicare PECOS PAC ID | 2961471594 |
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Medicare Enrollment ID | O20040929001087 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083790026 | NPI | - | NPPES |
4458397 | Medicaid | MI | |
3012794 | Medicaid | MI | |
4640974 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4704126534 (Michigan) | Primary |
Provider Name | Janet E Flynn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710063755 PECOS PAC ID: 5395645212 Enrollment ID: I20040108001112 |
Provider Name | Mary Bosman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821457854 PECOS PAC ID: 9133493976 Enrollment ID: I20170918003247 |
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