Provider Demographics
NPI:1437100674
Name:TOWNSEND MEDICAL CENTER, PLC
Entity Type:Organization
Organization Name:TOWNSEND MEDICAL CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-784-0141
Mailing Address - Street 1:400 HINCKLEY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-6125
Mailing Address - Country:US
Mailing Address - Phone:517-784-0141
Mailing Address - Fax:517-784-3866
Practice Address - Street 1:400 HINCKLEY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-6125
Practice Address - Country:US
Practice Address - Phone:517-784-0141
Practice Address - Fax:517-784-3866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICC4901OtherRAILROAD MEDICARE
MI0C86288Medicare ID - Type Unspecified