Provider Demographics
NPI:1467401745
Name:BIZON, JOHN GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GERARD
Last Name:BIZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3600 CAPITAL AVE SW
Mailing Address - Street 2:STE 204
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-9393
Mailing Address - Country:US
Mailing Address - Phone:269-979-6444
Mailing Address - Fax:269-979-6450
Practice Address - Street 1:3600 CAPITAL AVE SW
Practice Address - Street 2:STE 204
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9393
Practice Address - Country:US
Practice Address - Phone:269-979-6444
Practice Address - Fax:269-979-6450
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2010-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI0401382231207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1031248OtherPHYSICIAN HEALTH PLAN
MI4486856Medicaid
MI1031248OtherPHYSICIAN HEALTH PLAN
E16038Medicare UPIN