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NPI Code Detail

MEDICARE: LOWELL FAMILY MEDICAL CENTER

MEDICARE: LOWELL FAMILY MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10D14845OTHERMIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1295715779
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOWELL FAMILY MEDICAL CENTER
Provider Business Mailing Address
First Line : 2550 W MAIN ST
Second Line :
City : LOWELL
State : MI
Zip : 49331-8695
Country : US
Telephone Number : 616-252-5600
Fax Number : 616-252-5660
Provider Business Practice Location Address
First Line : 2550 W MAIN ST
Second Line :
City : LOWELL
State : MI
Zip : 49331-8695
Country : US
Telephone Number : 616-252-5600
Fax Number : 616-252-5660
Authorized Official
Title or Position : PARTNER
Name : DR. PAUL R GAUTHIER
Credential : DO
Telephone Number : 616-252-5600
Provider Enumeration Date : 01/19/2006
Last Update Date : 06/16/2009

Similar Medicare Providers

1780664466 — DR. JOHN BRENT WELLMAN DC
Practice Location Address:
2531 W MAIN ST
LOWELL, MI
49331-8695
Practice Phone: 616-897-8284
Practice Fax: 616-897-6810
1932219599 — JOHNATHAN G. MEIER DO
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LOWELL, MI
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1154431526 — PAUL R GAUTHIER DO
Practice Location Address:
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49331-8695
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1407966773 — DR. WAYNE A CHRISTENSON D.O.
Practice Location Address:
2550 W MAIN ST
LOWELL, MI
49331-8695
Practice Phone: 616-252-5600
Practice Fax: 616-252-5660
1467562041 — JAMES C LANG DO
Practice Location Address:
2550 W MAIN ST
LOWELL, MI
49331-8695
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Practice Fax: 616-252-5660
1275643546 — DR. TRACY L LIXIE D.O.
Practice Location Address:
2500 W MAIN ST
LOWELL, MI
49331-8695
Practice Phone: 616-252-5600
Practice Fax: 616-252-5660

Directions to “LOWELL FAMILY MEDICAL CENTER ” Practice Location

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