Healthcare Provider Details

I. General information

NPI: 1053589960
Provider Name (Legal Business Name): PARAGON HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2889 S 11TH ST
KALAMAZOO MI
49009-2123
US

IV. Provider business mailing address

2318 GULL RD STE B1
KALAMAZOO MI
49048-3619
US

V. Phone/Fax

Practice location:
  • Phone: 269-343-1296
  • Fax: 269-344-8485
Mailing address:
  • Phone: 269-341-4554
  • Fax: 269-381-3063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK C. RUMMEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 269-341-4554