Third Coast Family Practice | |
821 W Us Highway 10 31 Scottville MI 49454-9601 | |
(231) 757-2500 | |
(231) 757-9073 |
Full Name | Third Coast Family Practice |
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Speciality | Clinic/Center |
Location | 821 W Us Highway 10 31, Scottville, Michigan |
Authorized Official Name and Position | Craig Kenneth Matheson (OWNER AND SOLE MEMBER) |
Authorized Official Contact | 2317572500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Third Coast Family Practice 821 West U.s. Highway 10 Scottville MI 49454 Ph: (231) 757-2500 | Third Coast Family Practice 821 W Us Highway 10 31 Scottville MI 49454-9601 Ph: (231) 757-2500 |
NPI Number | 1205961745 |
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Provider Enumeration Date | 02/23/2007 |
Last Update Date | 02/17/2021 |
Medicare PECOS PAC ID | 3476529942 |
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Medicare Enrollment ID | O20040907000476 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205961745 | NPI | - | NPPES |
CLIA | Other | MI | 23D1038209 |
4615194 | Medicaid | MI | |
0855301234 | Other | MI | BLUE CROSS BLUE SHIELD ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 5101011416 (Michigan) | Primary |
Provider Name | Samya Hawley |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1336351048 PECOS PAC ID: 0042515538 Enrollment ID: I20190423000528 |
Compassionate House Visits, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 S Main St, Scottville, MI 49454 Phone: 248-332-1236 | |
Timothy R Woltanski, M.d. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 Thomas St, Scottville, MI 49454 Phone: 231-757-3743 Fax: 231-757-0071 | |
Northwest Michigan Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 W Beryl St, Scottville, MI 49454 Phone: 231-233-6178 |