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General NPI Number Information
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NPI Number | 1073681219
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Entity Type | Organization
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Legal Business Name | OWOSSO SURGICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 802 W KING ST SUITE M
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City | OWOSSO
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State | MI
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Zip | 48867-2100
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Country | US
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Telephone | 989-725-9846
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Fax | 989-725-5009
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Provider Business Mailing Address
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Address Line | 802 W KING ST SUITE M
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City | OWOSSO
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State | MI
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Zip | 48867-2100
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Country | US
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Telephone | 989-725-9846
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Fax | 989-725-5009
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. J M VACHHANI
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Credential | MD
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Telephone | 989-725-9846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | JV041531
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License Number State | MI
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