| Mr Ethan Jordan Lacourt, PA-C | |
|
100 Michigan St Ne, Grand Rapids, MI 49503-2560 | |
| (616) 391-3139 | |
| Not Available |
| Full Name | Mr Ethan Jordan Lacourt |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 100 Michigan St Ne, Grand Rapids, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003434507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5601010844 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Spectrum Health | Grand rapids, MI | Hospital |
| Spectrum Health Big Rapids Hospital | Big rapids, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Spectrum Health Primary Care Partners | 4587568647 | 1585 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Ethan Jordan Lacourt, PA-C 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 Ph: () - | Mr Ethan Jordan Lacourt, PA-C 100 Michigan St Ne, Grand Rapids, MI 49503-2560 Ph: (616) 391-3139 |
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