Barry Kitts, DO

Individual provider Active NPI Family Medicine Physician · Sparta, MI

NPI 1508860941 · NPPES record last updated May 25, 2010

Key facts

NPI
1508860941
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
5101008439 (MI)
Practice address
2111 12 Mile Rd NW
Sparta, MI 49345-9754
Phone
(616) 391-8470
Fax
(616) 391-8495
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101008439MIMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101008439 MI Yes

Addresses

Primary practice location

2111 12 Mile Rd NW
Sparta, MI 49345-9754

Mailing address

2111 12 Mile Rd NW
Sparta, MI 49345-9754
Phone (616) 391-8470

Other identifiers

IdentifierTypeStateIssuer
4195563MedicaidMI

Other providers in Sparta, MI

All providers in Sparta, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.