Provider Demographics
NPI:1598777351
Name:BATTLE CREEK SPORTS MEDICINE AND ORTHOPEDIC CENTER, PC
Entity Type:Organization
Organization Name:BATTLE CREEK SPORTS MEDICINE AND ORTHOPEDIC CENTER, PC
Other - Org Name:GREAT LAKES BONE AND JOINT CENTER, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-979-6360
Mailing Address - Street 1:2 HERITAGE OAK LN
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4250
Mailing Address - Country:US
Mailing Address - Phone:269-979-6360
Mailing Address - Fax:269-979-6380
Practice Address - Street 1:2 HERITAGE OAK LN
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4250
Practice Address - Country:US
Practice Address - Phone:269-979-6360
Practice Address - Fax:269-979-6380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty