Healthcare Provider Details

I. General information

NPI: 1790139475
Provider Name (Legal Business Name): FAMILY FIRST HEALTH CARE-YALE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5730 MAIN ST
LEXINGTON MI
48450-8800
US

IV. Provider business mailing address

5730 MAIN ST
LEXINGTON MI
48450-8800
US

V. Phone/Fax

Practice location:
  • Phone: 810-696-2088
  • Fax: 810-696-2094
Mailing address:
  • Phone: 810-696-2088
  • Fax: 810-696-2094

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: DR. SCOTT MCPHILIMY
Title or Position: OWNER
Credential: D.O.
Phone: 810-387-9355