Provider Demographics
NPI:1972849123
Name:SPARROW CARSON HOSPITAL
Entity Type:Organization
Organization Name:SPARROW CARSON HOSPITAL
Other - Org Name:SPARROW MEDICAL GROUP EAR, NOSE AND THROAT CARSON CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-584-3971
Mailing Address - Street 1:406 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48811-9693
Mailing Address - Country:US
Mailing Address - Phone:989-584-3131
Mailing Address - Fax:
Practice Address - Street 1:102 S 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARSON CITY
Practice Address - State:MI
Practice Address - Zip Code:48811-5115
Practice Address - Country:US
Practice Address - Phone:989-584-6217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty