MEDICARE: SPARROW EATON HOSPITAL

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1598820672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPARROW EATON HOSPITAL

Provider Business Mailing Address
First Line	:	1701 LAKE LANSING RD
Second Line	:	SUITE 100
City	:	LANSING
State	:	MI
Zip	:	48912-3798
Country	:	US
Telephone Number	:	517-485-0001
Fax Number	:	517-485-1138

Provider Business Practice Location Address
First Line	:	123 LANSING ST
Second Line	:
City	:	CHARLOTTE
State	:	MI
Zip	:	48813-1696
Country	:	US
Telephone Number	:	517-543-0600
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF SPECIALTY CLINICS
Name	:	TAMMY MERRITT
Credential	:
Telephone Number	:	517-543-1050

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	02/13/2020

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