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NPI Code Detail

MEDICARE: JILL P BARSEN P.A.C

MEDICARE: JILL P BARSEN P.A.C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601006298MI

General Provider Information

NPI Number : 1295008217
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL P BARSEN P.A.C
Provider Business Mailing Address
First Line : PO BOX 427
Second Line :
City : HILLMAN
State : MI
Zip : 49746-0427
Country : US
Telephone Number : 989-354-2197
Fax Number : 989-356-6524
Provider Business Practice Location Address
First Line : 205 S BRADLEY HWY
Second Line :
City : ROGERS CITY
State : MI
Zip : 49779-2137
Country : US
Telephone Number : 989-734-2052
Fax Number : 989-734-7390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2012
Last Update Date : 08/06/2012

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