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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Y00000X | Otolaryngology | 5101013761 | MI | Allopathic & Osteopathic Physicians |
Street Address |
1114 CHARLEVOIX AVE |
City | PETOSKEY |
State | MI |
Zip Code | 49770 |
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 |
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 |
Find all providers in zip 49770 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
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. |
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 |
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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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.