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General NPI Number Information
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NPI Number | 1770559320
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Entity Type | Individual
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Provider Name | JEFFREY B STOWITTS DO
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 1014 EAST WASHINGTON
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City | GREENVILLE
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State | MI
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Zip | 48838
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Country | US
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Telephone | 616-754-7145
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Fax | 616-754-7110
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Provider Business Mailing Address
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Address Line | 406 EAST ELM STREET PO BOX 730
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City | CARSON CITY
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State | MI
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Zip | 48811
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Country | US
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Telephone | 989-584-3131
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Fax | 989-584-6734
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101012632
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License Number State | MI
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