Healthcare Provider Details

I. General information

NPI: 1568406247
Provider Name (Legal Business Name): JEFFREY S SEARS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CLINTON ST
MUSKEGON MI
49442-5502
US

IV. Provider business mailing address

PO BOX 1847
MUSKEGON MI
49443-1847
US

V. Phone/Fax

Practice location:
  • Phone: 231-728-5692
  • Fax:
Mailing address:
  • Phone: 231-727-4444
  • Fax: 231-728-4789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number5101010919
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number036161173
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number5101010919
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: