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NPI Code Detail

MEDICARE: ADDISON COMMUNITY PHYSICIAN SERVICES ASSOCIATION

MEDICARE: ADDISON COMMUNITY PHYSICIAN SERVICES ASSOCIATION
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
1208600000XSurgery Physician
2363AS0400XSurgical Physician Assistant
3363A00000XPhysician Assistant
42085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1700H111110OTHERMIBCBS OF MI

General Provider Information

NPI Number : 1912066093
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADDISON COMMUNITY PHYSICIAN SERVICES ASSOCIATION
Provider Business Mailing Address
First Line : 135 S PROSPECT ST
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-7914
Country : US
Telephone Number : 734-547-4900
Fax Number : 734-547-1161
Provider Business Practice Location Address
First Line : 135 S PROSPECT ST
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-7914
Country : US
Telephone Number : 734-547-4900
Fax Number : 734-547-1161
Authorized Official
Title or Position : PATIENT ACCOUNTS MANAGER
Name : JOANN K SCRIPKO
Credential :
Telephone Number : 734-547-1174
Provider Enumeration Date : 12/06/2006
Last Update Date : 03/11/2026

Similar Medicare Providers

1871592188 — DR. KRISTIN A KESKEY MD
Practice Location Address:
135 S PROSPECT ST
YPSILANTI, MI
48198-7914
Practice Phone: 734-547-1066
Practice Fax: 734-547-1072
1770573958 — DR. ELAINA VAYNTRUB MD
Practice Location Address:
135 S PROSPECT ST
YPSILANTI, MI
48198-7914
Practice Phone: 734-547-1066
Practice Fax: 734-547-1072
1386621407 — JAMOKAY P TAYLOR MD
Practice Location Address:
135 S PROSPECT ST
YPSILANTI, MI
48198-7914
Practice Phone: 734-547-4900
Practice Fax: 734-547-4901
1669493664 — FOREST HEALTH MEDICAL CENTER LLC
Practice Location Address:
135 S PROSPECT ST
YPSILANTI, MI
48198-7914
Practice Phone: 734-547-4722
Practice Fax: 734-547-1461
1437173481 — STEVEN C POPLAWSKI MD
Practice Location Address:
135 S PROSPECT ST
YPSILANTI, MI
48198-7914
Practice Phone: 734-547-1069
Practice Fax: 734-547-1070
1871694083 — DETROIT SURGICAL SPECIALIST, P.C.
Practice Location Address:
135 S PROSPECT ST
YPSILANTI, MI
48198-7914
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Practice Fax: 734-547-4901

Directions to “ADDISON COMMUNITY PHYSICIAN SERVICES ASSOCIATION ” Practice Location

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