| Organization Name: | OTSEGO MEMORIAL HOSPITAL |
| NPI Number: | 1538328364 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS R. LEMON (CEO) |
| Mailing Address: | 3040 Bourn St Lewiston |
| State: | MI US |
| Postal Code: | 497568134 |
| Phone Number: | 9897864877 |
| Fax Number: | 9897862187 |
| NPI Enumeration Date: | 06/06/2008 |
| NPI Last Update Date: | 05/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 690020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |