MEDICARE: FALLS CLINIC, P.C.

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
1	207Q00000X	Family Medicine Physician	5101007427	MI
2	208600000X	Surgery Physician	4301036114	MI

General Provider Information

NPI Number	:	1396831251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALLS CLINIC, P.C.

Provider Business Mailing Address
First Line	:	211 S 4TH ST
Second Line	:
City	:	CRYSTAL FALLS
State	:	MI
Zip	:	49920-1503
Country	:	US
Telephone Number	:	906-875-6681
Fax Number	:	906-875-3090

Provider Business Practice Location Address
First Line	:	211 S 4TH ST
Second Line	:
City	:	CRYSTAL FALLS
State	:	MI
Zip	:	49920-1503
Country	:	US
Telephone Number	:	906-875-6681
Fax Number	:	906-875-3090

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. BEVERLY A. SMITH
Credential	:
Telephone Number	:	906-875-6681

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	09/11/2025

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