Healthcare Provider Details

I. General information

NPI: 1457726770
Provider Name (Legal Business Name): THOMAS KIZY MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 COLUMBIA ST
ALGONAC MI
48001
US

IV. Provider business mailing address

PO BOX 477
ALGONAC MI
48001-0477
US

V. Phone/Fax

Practice location:
  • Phone: 810-671-3190
  • Fax: 810-671-3263
Mailing address:
  • Phone: 810-720-5715
  • Fax: 810-732-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS KIZY
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 810-671-3190