MEDICARE: KATHRYN L ANASON MD

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	207V00000X	Obstetrics & Gynecology Physician	4301047870	MI

General Provider Information

NPI Number	:	1427020908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN L ANASON MD

Provider Business Mailing Address
First Line	:	100 MICHIGAN ST NE
Second Line	:	MC 845
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-2560
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	722 LOCUST ST
Second Line	:	SUITE 2
City	:	BIG RAPIDS
State	:	MI
Zip	:	49307-2040
Country	:	US
Telephone Number	:	231-592-4200
Fax Number	:	231-527-6859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	09/30/2016

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