Provider Demographics
NPI:1275727331
Name:BATTLE CREEK SURGICAL, PC
Entity Type:Organization
Organization Name:BATTLE CREEK SURGICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-969-6126
Mailing Address - Street 1:215 E ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-2828
Mailing Address - Country:US
Mailing Address - Phone:269-969-6126
Mailing Address - Fax:269-969-6136
Practice Address - Street 1:215 E ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-2828
Practice Address - Country:US
Practice Address - Phone:269-969-6126
Practice Address - Fax:269-969-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010126660208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4710095Medicaid
MI0251311764OtherBCBSM
MI4710095Medicaid
MIH16603Medicare UPIN