GREAT LAKES EAR NOSE & THROAT SPECIALISTS PC


Address: 1114 Charlevoix Ave, Petoskey, MI 49770
Phone: 2314399700

GREAT LAKES EAR NOSE & THROAT SPECIALISTS PC (NPI# 1184123150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184123150
Entity Type Organization
Organization Name GREAT LAKES EAR NOSE & THROAT SPECIALISTS PC
Practice Address 1114 Charlevoix Ave
Petoskey
MI 49770
Mailing Address 1242 Autumn Lane
Petoskey
MI 49770
Practice Telephone 2314399700
Practice Fax Number 2314399709
Mailing Telephone 2318381571
Enumeration Date 2018-02-06
Last Update Date 2018-02-06
Authorized Official Name KEVIN L GIETZEN (DOCTOR)
Authorized Official Telephone 2318381571
Authorized Official Credential DO
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology 5101013761 MI Allopathic & Osteopathic Physicians

Office Location

Street Address 1114 CHARLEVOIX AVE
City PETOSKEY
State MI
Zip Code 49770

Providers in the same location

NPI Name Taxonomy Address Enumeration
1770548331 Julie M Izzard Advanced Practice Midwife 1114 Charlevoix Ave, Petoskey, MI 49770-9701 2006-04-18
1821273798 Shannon R Bieber Physician Assistant 1114 Charlevoix Ave, Petoskey, MI 49770-9701 2008-01-09
1497775514 Bradley T Vanassche Radiology 1114 Charlevoix Ave, Petoskey, MI 49770-9701 2006-07-20
1811924160 Matthew L Visconti Md LLC Radiology 1114 Charlevoix Ave, Petoskey, MI 49770-9701 2006-06-26
1306883202 Matthew L Visconti Radiology 1114 Charlevoix Ave, Petoskey, MI 49770-9701 2006-05-31
1003853144 Mvp Imaging Plc Radiology 1114 Charlevoix Ave, Petoskey, MI 49770-9701 2006-05-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780231985 Olivia Michelle Seaman Pharmacist 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 2019-08-22
1649733148 Harbor Hall, Inc. Clinic/Center 302 Orchard Ridge Drive, Petoskey, MI 49770 2019-04-11
1053802942 Devin Hueston Dentist 231 State St Ste 3, Petoskey, MI 49770 2018-05-25
1720585037 Jacob Kenneth Tracy Counselor 410 E Lake Street, Suite 100, Petoskey, MI 49770 2018-04-12
1013424191 Timothy Robert La Gasse Nurse Practitioner 401 Connable Ave, Petoskey, MI 49770 2018-01-10
1609303676 Shauna Sue Stark Nurse Practitioner 560 W Mitchell St Ste 505, Petoskey, MI 49770 2017-05-22
1053851519 Maureen Todd Counselor 703 Emmet St, Petoskey, MI 49770 2017-03-03
1457719239 Hufford Vision & Eye Care, PC Optometrist 560 West Mitchell, Suite 214, Petoskey, MI 49770 2016-02-08
1053779439 Kaylyn Schiemann Specialist/Technologist 1980 Maxwell Rd, Petoskey, MI 49770 2016-02-01
1669839130 Stieber Pediatric Dentistry Pllc Clinic/Center 1605 Us 131 Highway, Petoskey, MI 49770 2016-01-28
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497091078 Henry L Singer Otolaryngology 2341 Tor Ln, Petoskey, MI 49770-9768 2012-12-30
1598773939 Marc A Feeley Otolaryngology 560 W Mitchell St Ste 250, Petoskey, MI 49770-2277 2006-08-03
1710906425 Howard J Beck Otolaryngology 1118 Valley View Ave, Petoskey, MI 49770-3119 2006-07-19
1942626726 Howard J Beck Md Pllc Otolaryngology 416 Connable Ave, Petoskey, MI 49770-2212 2014-03-17
1083815559 Melissa Linnae Somers Otolaryngology 560 W Mitchell St Ste 250, Petoskey, MI 49770-2277 2007-05-30
1578624946 Thomas Russell Spooner Otolaryngology 560 W Mitchell St Ste 250, Petoskey, MI 49770-2277 2006-12-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104445980 Anuja Dharap Otolaryngology 35630 Grand River Ave Apt 217, Farmington Hills, MI 48335-3120 2020-04-13
1598311334 Cogent Medical Group Pllc Otolaryngology 28300 Orchard Lake Rd Ste 101, Farmington Hills, MI 48334-3704 2019-08-16
1073025334 Robert J Stachler Md PC Otolaryngology 33200 W. 14 Mile Rd., Ste. 240, West Bloomfield, MI 48322 2017-10-26
1255878062 W.a. Foote Memorial Hospital, Inc Otolaryngology 205 N.east Ave, Jackson, MI 49201 2017-01-31
1174905822 Scott Jacob Schwartz Otolaryngology 6900 Orchard Lake Rd Ste 314, West Bloomfield, MI 48322-3457 2015-06-18
1669868402 Cameron M Heilbronn Otolaryngology 21000 E 12 Mile Rd Ste 111, Saint Clair Shores, MI 48081-1156 2015-04-08
1104230523 Gary Zachary White Otolaryngology 300 North Ave Ste 1400, Battle Creek, MI 49017 2014-06-13
1437574530 Beacon Medical Group, Inc. Otolaryngology 711 S Health Pkwy Ste 1, Medical Office Building #1, Three Rivers, MI 49093-8354 2014-02-26
1124361621 Eric Fahed Succar Otolaryngology 44200 Woodward Ave Ste 201, Pontiac, MI 48341-5045 2013-04-03
1396086286 Nathan Vandjelovic Otolaryngology 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 2013-03-03
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Competitor

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City PETOSKEY
Zip Code 49770

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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