Provider Demographics
NPI:1649393331
Name:GENE E KIELHORN, D.O.,P.C.
Entity Type:Organization
Organization Name:GENE E KIELHORN, D.O.,P.C.
Other - Org Name:COLUMBIA MEDICAL CENTER, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEPPERT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-592-8033
Mailing Address - Street 1:212 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-9114
Practice Address - Country:US
Practice Address - Phone:517-592-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty