Great Lakes Obstetric Gynecological Specialists PLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MK008760 Issued in MI

Legal business name

GREAT LAKES OBSTETRIC GYNECOLOGICAL SPECIALISTS PLC

Practice address

1775 Wells Ave
Muskegon, MI 49442-2459

Phone

(231) 773-9048

Fax

(231) 777-1218

NPI assigned

Jun 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark T Karnes, DO

Title

Doctor

Phone

(231) 773-9048

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1366478026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 WELLS AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494422459",
            "telephone_number": "231-773-9048",
            "fax_number": "231-777-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 WELLS AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494422459",
            "telephone_number": "231-773-9048",
            "fax_number": "231-777-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES OBSTETRIC GYNECOLOGICAL SPECIALISTS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "KARNES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "231-773-9048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "MK008760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433625011",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "461890011",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433624011",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483147511",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.