NPI Code Details Logo

NPI 1629116967

NPI 1629116967 : AUBURN CLINIC L.L.C. : LIVONIA, MI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1629116967
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    AUBURN CLINIC L.L.C. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/01/2007
-----------------------------------------------------
    Last Update Date     |    11/25/2008
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    38253 ANN ARBOR RD 
-----------------------------------------------------
    City                 |    LIVONIA
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48150-3432
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    734-464-9200
-----------------------------------------------------
    Fax                  |    734-464-0017
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    38253 ANN ARBOR RD 
-----------------------------------------------------
    City                 |    LIVONIA
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48150-3432
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    734-464-9200
-----------------------------------------------------
    Fax                  |    734-464-0017
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PHYSICIAN
-----------------------------------------------------
    Name                 |    DR. RICHARD ANTHONY OZOG 
-----------------------------------------------------
    Credential           |    DO
-----------------------------------------------------
    Telephone            |    734-464-9200
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    RO008962
-----------------------------------------------------
    License Number State |    MI
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.