Provider Demographics
NPI:1184896672
Name:BLISSFIELD FAMILY CARE PLLC
Entity type:Organization
Organization Name:BLISSFIELD FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-486-5456
Mailing Address - Street 1:9205 E US HIGHWAY 223
Mailing Address - Street 2:PO BOX 86
Mailing Address - City:BLISSFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49228-9665
Mailing Address - Country:US
Mailing Address - Phone:517-486-5456
Mailing Address - Fax:517-486-0226
Practice Address - Street 1:9205 E US HIGHWAY 223
Practice Address - Street 2:
Practice Address - City:BLISSFIELD
Practice Address - State:MI
Practice Address - Zip Code:49228-9665
Practice Address - Country:US
Practice Address - Phone:517-486-5456
Practice Address - Fax:517-486-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILB073625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P03930Medicare PIN