MEDICARE: DR. JOHN GERARD BIZON M.D.

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	207Y00000X	Otolaryngology Physician	0401382231	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1031248	OTHER	MI	PHYSICIAN HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467401745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN GERARD BIZON M.D.

Provider Business Mailing Address
First Line	:	3600 CAPITAL AVE SW
Second Line	:	STE 204
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-9393
Country	:	US
Telephone Number	:	269-979-6444
Fax Number	:	269-979-6450

Provider Business Practice Location Address
First Line	:	3600 CAPITAL AVE SW
Second Line	:	STE 204
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-9393
Country	:	US
Telephone Number	:	269-979-6444
Fax Number	:	269-979-6450

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

Provider Enumeration Date	:	05/06/2006
Last Update Date	:	07/13/2010

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