Provider Demographics
NPI:1225293848
Name:STRONG MEDICAL CENTER PC
Entity Type:Organization
Organization Name:STRONG MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:906-884-2804
Mailing Address - Street 1:401 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ONTONAGON
Mailing Address - State:MI
Mailing Address - Zip Code:49953-1444
Mailing Address - Country:US
Mailing Address - Phone:906-884-2804
Mailing Address - Fax:906-884-6231
Practice Address - Street 1:401 S 7TH ST
Practice Address - Street 2:
Practice Address - City:ONTONAGON
Practice Address - State:MI
Practice Address - Zip Code:49953-1444
Practice Address - Country:US
Practice Address - Phone:906-884-2804
Practice Address - Fax:906-884-6231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS024363261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1042847Medicaid
MI0806600141OtherBLUE CROSS/BLUE SHIELD
MI1042847Medicaid