Provider Demographics
NPI:1043484322
Name:THE DOCTORS GROUP, P.C.
Entity Type:Organization
Organization Name:THE DOCTORS GROUP, P.C.
Other - Org Name:LAKEVIEW FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-969-6240
Mailing Address - Street 1:391 S SHORE DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5446
Mailing Address - Country:US
Mailing Address - Phone:269-969-6240
Mailing Address - Fax:269-969-6219
Practice Address - Street 1:391 S SHORE DR
Practice Address - Street 2:SUITE 320
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5446
Practice Address - Country:US
Practice Address - Phone:269-969-6240
Practice Address - Fax:269-969-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P09540Medicare PIN