| Dr Charles J Lilly, MD | |
|
2890 Health Parkway, Mount Pleasant, MI 48858 | |
| (989) 772-3886 | |
| (989) 773-6267 |
| Full Name | Dr Charles J Lilly |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 2890 Health Parkway, Mount Pleasant, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043311848 | NPI | - | NPPES |
| 1644906 | Medicaid | MI | |
| 00370822 | Other | MI | BLUE CROSS BLUE SHIELD MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 4301048544 (Michigan) | Primary |
| Entity Name | Charles J Lilly Md Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619167996 PECOS PAC ID: 4284712506 Enrollment ID: O20080425000647 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Charles J Lilly, MD 350 Cedar Dr, Mount Pleasant, MI 48858-9027 Ph: (989) 772-4403 | Dr Charles J Lilly, MD 2890 Health Parkway, Mount Pleasant, MI 48858 Ph: (989) 772-3886 |
Dr. Thomas M Keating, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 2890 Health Parkway, Mount Pleasant, MI 48858 Phone: 989-772-0923 Fax: 989-773-6267 | |
Michael James Moutsatson, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2890 Health Parkway, Mount Pleasant, MI 48858 Phone: 989-953-9777 Fax: 989-773-6267 |