Lee O Stuart (NPI# 1225147804, PAC ID# 8224018262) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1225147804 |
PAC ID by PECOS | 8224018262 |
Professional Enrollment ID | I20040721001057 |
Full Name | Lee O Stuart |
Organization Legal Name | PENNOCK HOSPITAL |
Address |
4294 Laurel Dr Lake Odessa MI 48849-8430 |
Phone Number | 6163747660 |
Gender | M |
Credential | MD |
Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE |
Graduation Year | 1976 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 4587551015 |
Number of Group Practice Members | 23 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
231339 | |
230038 | SPECTRUM HEALTH-BUTTERWORTH CAMPUS |
230230 | EDWARD W SPARROW HOSPITAL |
Address | Phone | Organization |
---|---|---|
1005 W Green St, 300 Spectrum Health Pennock Surg Serv, Hastings, MI 49058-1725 | 2699488411 | PENNOCK HOSPITAL |
4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 6163747660 | PENNOCK HOSPITAL |
Organization Legal Name | PENNOCK HOSPITAL |
Physicians | 29 |
Name | Specialty | Organization | Address |
---|---|---|---|
Daniel Adam Blasch | Physician Assistant | Pennock Hospital | 1009 W Green St, Hastings, MI 49058-1710 |
Donald Gingerich | Family Medicine | Pennock Hospital | 2776 S State Rd, Spectrum Health Pennock Family Med, Ionia, MI 48846-8472 |
Susan E Haasch | Occupational Therapy | Pennock Hospital | 155 E Cross St, Clarksville, MI 48815-9621 |
Laurie S Braker | Family Medicine | Pennock Hospital | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 |
Douglas Smendik | Family Practice | Pennock Hospital | 12851 W M 179 Hwy, Spectrum Health Pennock Family Med, Wayland, MI 49348-9318 |
Bryan S Kamps | Orthopedic Surgery | Pennock Hospital | 1009 W Green St, Hastings, MI 49058-1710 |
Cindy Marie Bigler | Nurse Practitioner | Pennock Hospital | 1009 W Green St, Hastings, MI 49058-1710 |
Eric S Leep | Pain Management | Pennock Hospital | 1005 W Green St, 300 Spectrum Health Pennock Surg Serv, Hastings, MI 49058-1725 |
Tami Lynn Pettenger | Nurse Practitioner | Pennock Hospital | 1009 W Green St, Hastings, MI 49058-1710 |
Max D Rappaport | General Surgery | Pennock Hospital | 1009 W Green St, Hastings, MI 49058-1710 |
Street Address |
4294 LAUREL DR |
City | LAKE ODESSA |
State | MI |
Zip | 48849-8430 |
Name | Specialty | Organization | Address |
---|---|---|---|
Laurie S Braker | Family Medicine | Pennock Hospital | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 |
Kristy Laura Penick | Physical Therapy | Total Health Center Inc | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 |
Mohinder P Chawdhry | Physical Therapy | Total Health Center Inc | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 |
Name | Specialty | Organization | Address |
---|---|---|---|
Clarence R Barnett | Family Medicine | 1020 4th Ave, Lake Odessa, MI 48849-1004 | |
Sandeep Khurana | Cardiovascular Disease (cardiology) | 1020 4th Ave, Lake Odessa, MI 48849-1004 | |
Julie Michelle Powell | Optometry | Lansing Ophthalmology, PC | 1170 Jordan Lake St, Lake Odessa, MI 48849-1212 |
Chad R Hickey | Chiropractic | 7857 Velte Rd, Lake Odessa, MI 48849-9497 |
City | LAKE ODESSA |
Zip Code | 48849 |
Specialty | FAMILY MEDICINE |
City + Specialty | LAKE ODESSA + FAMILY MEDICINE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.