| John Jeffrey Italiano, DO | |
|
3443 Farr Rd, Fruitport, MI 49415-8779 | |
| (231) 672-2900 | |
| Not Available |
| Full Name | John Jeffrey Italiano |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 3443 Farr Rd, Fruitport, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316681232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 5101027462 (Michigan) | Secondary |
| 207Q00000X | Family Medicine | 5101027462 (Michigan) | Primary |
| Entity Name | Signify Health Medical Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20210405000855 |
| Mailing Address | Practice Location Address |
|---|---|
| John Jeffrey Italiano, DO 1508 Bluebird Rd Apt 11, Grand Haven, MI 49417-9012 Ph: () - | John Jeffrey Italiano, DO 3443 Farr Rd, Fruitport, MI 49415-8779 Ph: (231) 672-2900 |
Chase Burton, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3443 Farr Rd, Fruitport, MI 49415 Phone: 231-672-8284 | |
Dr. Kristen Kay Woods, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3443 Farr Rd, Fruitport, MI 49415 Phone: 231-672-2900 Fax: 231-672-2901 | |
Nathan Dills, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 3443 Farr Rd, Fruitport, MI 49415 Phone: 231-672-2900 | |
Fizza Agha, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3443 Farr Rd, Fruitport, MI 49415 Phone: 231-727-5209 | |
Lauren Mcgraw, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3443 Farr Rd, Fruitport, MI 49415 Phone: 231-672-2900 | |
Dr. Faith Elizabeth Sharp, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3443 Farr Rd, Fruitport, MI 49415 Phone: 231-672-2900 | |
Darrell S Roelandt, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3443 Farr Rd, Fruitport, MI 49415 Phone: 231-672-2900 Fax: 231-672-2901 |