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General NPI Number Information
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NPI Number | 1699060665
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Entity Type | Individual
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Provider Name | JON ROBERT FELT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 100 MICHIGAN ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone | 616-988-8220
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Fax | 313-993-7166
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Provider Business Mailing Address
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Address Line | 4100 EMBASSY DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2416
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Country | US
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Telephone |
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Fax | 313-966-0665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301098464
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 4301098464
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301098464
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License Number State | MI
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