MEDICARE: MED STOP PC

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
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1417057670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED STOP PC

Provider Business Mailing Address
First Line	:	680 WEST COLUMBIA AVE
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-3028
Country	:	US
Telephone Number	:	269-965-4500
Fax Number	:	269-965-1150

Provider Business Practice Location Address
First Line	:	680 WEST COLUMBIA AVE
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-3028
Country	:	US
Telephone Number	:	269-965-4500
Fax Number	:	269-965-1150

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS GLENN HICKS
Credential	:	MD
Telephone Number	:	269-965-4500

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/22/2020

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Directions to “MED STOP PC ” Practice Location

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