| Lighthouse Family Medicine, Pllc | |
|
4071 24th Ave Fort Gratiot MI 48059-3801 | |
| (810) 824-4222 | |
| (810) 824-4220 |
| Full Name | Lighthouse Family Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4071 24th Ave, Fort Gratiot, Michigan |
| Authorized Official Name and Position | G. Blair Dowden (MEDICAL DOCTOR) |
| Authorized Official Contact | 8108244222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Family Medicine, Pllc 4071 24th Ave Fort Gratiot MI 48059-3801 Ph: (810) 824-4222 | Lighthouse Family Medicine, Pllc 4071 24th Ave Fort Gratiot MI 48059-3801 Ph: (810) 824-4222 |
| NPI Number | 1114222031 |
|---|---|
| Provider Enumeration Date | 01/25/2011 |
| Last Update Date | 01/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114222031 | NPI | - | NPPES |
| 1750379194 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301088847 (Michigan) | Primary |
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