MEDICARE: MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	282NR1301X	Rural Acute Care Hospital
2	208D00000X	General Practice Physician
3	261QR1300X	Rural Health Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23-8660	OTHER	MI	MEDICARE OSCAR/CERTIFICATION 2

General Provider Information

NPI Number	:	1639420557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	271 MCCOY RD W
Second Line	:
City	:	GAYLORD
State	:	MI
Zip	:	49735-8253
Country	:	US
Telephone Number	:	989-731-7777
Fax Number	:	989-731-7776

Provider Business Practice Location Address
First Line	:	3860 S STRAITS HWY
Second Line	:
City	:	INDIAN RIVER
State	:	MI
Zip	:	49749
Country	:	US
Telephone Number	:	231-238-0581
Fax Number	:	231-238-0586

Authorized Official
Title or Position	:	PRES AMBULATORY & BUS DEVELOPMENT
Name	:	MICHAEL FRYE
Credential	:	MD
Telephone Number	:	704-458-8010

Provider Enumeration Date	:	10/02/2012
Last Update Date	:	04/17/2026

Similar Medicare Providers

1720920341 — GLOMBOWSKI LLC
Practice Location Address:

3944 S STRAITS HWY
INDIAN RIVER, MI
49749-5135

Practice Phone: 231-238-2499
Practice Fax: 231-238-2496

1164206637 — MARJORIE LEE BEIGLE AGNP
Practice Location Address:

3860 S STRAITS HWY
INDIAN RIVER, MI
49749-5146

Practice Phone: 231-238-0581
Practice Fax:

1699771857 — MARGARET LYNN RORICK FNP-C
Practice Location Address:

3696 S STRAITS HWY
INDIAN RIVER, MI
49749-5136

Practice Phone: 231-238-0581
Practice Fax: 231-238-0586

1720071657 — JEFFREY JAY KIEL DO
Practice Location Address:

2030 S STRAITS HWY
INDIAN RIVER, MI
49749-9792

Practice Phone: 231-649-0935
Practice Fax:

1245201581 — DR. LISA C MCELROY PHD
Practice Location Address:

1730 SHAWNEE AVE
INDIAN RIVER, MI
49749-8705

Practice Phone: 214-998-4888
Practice Fax:

1487625174 — MRS. KATHRYN A SNOW-MCCAFFREY APRN MSN GNP
Practice Location Address:

7268 CAMPBELL TRL
INDIAN RIVER, MI
49749-9221

Practice Phone: 231-420-3887
Practice Fax: 231-526-2212

Directions to “MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.