| Laurie S Braker Md Plc | |
|
4294 Laurel Dr Lake Odessa MI 48849-8430 | |
| (616) 374-7660 | |
| (616) 374-0270 |
| Full Name | Laurie S Braker Md Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 4294 Laurel Dr, Lake Odessa, Michigan |
| Authorized Official Name and Position | Laurie Braker (OWNER) |
| Authorized Official Contact | 6163747660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurie S Braker Md Plc 4294 Laurel Dr Po Box 578 Lake Odessa MI 48849-8430 Ph: (616) 374-7660 | Laurie S Braker Md Plc 4294 Laurel Dr Lake Odessa MI 48849-8430 Ph: (616) 374-7660 |
| NPI Number | 1942509666 |
|---|---|
| Provider Enumeration Date | 03/21/2011 |
| Last Update Date | 03/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942509666 | NPI | - | NPPES |
| 4765084 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301080130 (Michigan) | Primary |
Pennock Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4294 Laurel Dr, Lake Odessa, MI 48849 Phone: 616-374-7660 | |
Clarence Richard Barnett Md Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1020 4th Ave, Lake Odessa, MI 48849 Phone: 616-374-8881 Fax: 616-374-4220 | |
Brian W Swanton Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4294 Laurel Dr, Lake Odessa, MI 48849 Phone: 616-374-7660 Fax: 616-374-0270 | |
Pennock Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4294 Laurel Dr, Lake Odessa, MI 48849 Phone: 616-374-7660 Fax: 616-374-0270 |