Provider Demographics
NPI:1740479278
Name:WILLIAM KERR MD PC
Entity type:Organization
Organization Name:WILLIAM KERR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ARCHIBALD
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-731-0658
Mailing Address - Street 1:650 N CENTER AVE
Mailing Address - Street 2:SUITE 3 B
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1682
Mailing Address - Country:US
Mailing Address - Phone:989-731-0658
Mailing Address - Fax:989-731-0681
Practice Address - Street 1:650 N CENTER AVE
Practice Address - Street 2:SUITE 3 B
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1682
Practice Address - Country:US
Practice Address - Phone:989-731-0658
Practice Address - Fax:989-731-0681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0690721OtherBLUE CROSS BLUE SHIELD
MI0690721OtherBLUE CROSS BLUE SHIELD
MIF88857Medicare UPIN