Organization Name: | OTSEGO MEMORIAL HOSPITAL |
NPI Number: | 1992146807 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS R LEMON (CEO) |
Mailing Address: | 2572 N Us Highway 131 Elmira |
State: | MI US |
Postal Code: | 497308252 |
Phone Number: | 9897317708 |
Fax Number: | |
NPI Enumeration Date: | 07/09/2013 |
NPI Last Update Date: | 07/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |