Provider Demographics
NPI:1295791630
Name:FAMILY PRACTICE IN THE WOODS PC
Entity type:Organization
Organization Name:FAMILY PRACTICE IN THE WOODS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:STYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-399-9680
Mailing Address - Street 1:PO BOX 8155
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49422-8155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 WAUKAZOO DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-2556
Practice Address - Country:US
Practice Address - Phone:616-399-9680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704185046363L00000X
MI4301048380207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4796877Medicaid
MI0807015771OtherDR. STYER'S BCBS NUMBER
MI1749990Medicaid
MI5008755300OtherAMY ROBBINS' BCBS NUMBER
MIQ49392Medicare UPIN
MI08007375Medicare ID - Type UnspecifiedDR. STYER'S RAILROAD MEDI
MI1749990Medicaid
MI5008755300OtherAMY ROBBINS' BCBS NUMBER
MI0P20340Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
MIP20340001Medicare ID - Type UnspecifiedDR. STYER'S MEDICARE NUMB