| Fennville Family Medicine | |
|
200 North Maple Street Fennville MI 49408-0664 | |
| (269) 561-8761 | |
| (269) 561-6040 |
| Full Name | Fennville Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 200 North Maple Street, Fennville, Michigan |
| Authorized Official Name and Position | Kenneth Earl Kratzer (PRESIDENT) |
| Authorized Official Contact | 2695618761 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fennville Family Medicine Po Box 664 Fennville MI 49408-0664 Ph: (269) 561-8761 | Fennville Family Medicine 200 North Maple Street Fennville MI 49408-0664 Ph: (269) 561-8761 |
| NPI Number | 1174705933 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174705933 | NPI | - | NPPES |
| 111035922 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Fennville Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Maple St, Fennville, MI 49408 Phone: 269-561-8761 Fax: 269-686-5438 |