Provider Demographics
NPI:1407071038
Name:MEDPARTNERS, P.L.C.
Entity Type:Organization
Organization Name:MEDPARTNERS, P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LIZA
Authorized Official - Last Name:LAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-779-7200
Mailing Address - Street 1:2480 W CAMPUS DR
Mailing Address - Street 2:BUILDING B, SUITE 300
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-5414
Mailing Address - Country:US
Mailing Address - Phone:989-779-7200
Mailing Address - Fax:989-779-7100
Practice Address - Street 1:2480 W CAMPUS DR
Practice Address - Street 2:BUILDING B, SUITE 300
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-5414
Practice Address - Country:US
Practice Address - Phone:989-779-7200
Practice Address - Fax:989-779-7100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110C710130OtherBCBS
MI0N32780Medicare ID - Type Unspecified