Healthcare Provider Details

I. General information

NPI: 1437060720
Provider Name (Legal Business Name): SPARROW CARSON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S 3RD ST STE 300
CARSON CITY MI
48811-5115
US

IV. Provider business mailing address

102 S 3RD ST STE 300
CARSON CITY MI
48811-5115
US

V. Phone/Fax

Practice location:
  • Phone: 989-584-6321
  • Fax:
Mailing address:
  • Phone: 989-584-6321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: MISTY GUNTER RUSSIAN
Title or Position: REGIONAL MANAGER
Credential:
Phone: 517-253-6308