Townline Family PC
Organization Active NPI Optometrist · Kalkaska, MI
NPI 1679968044 · NPPES record last updated Apr 4, 2015
Key facts
- NPI
- 1679968044
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901004199 (MI)
- Legal business name
- TOWNLINE FAMILY PC
- Practice address
- 882 M 72 NW
Kalkaska, MI 49646-8787 - Phone
- (231) 258-9781
- Fax
- (231) 258-0616
- NPI assigned
- Apr 2, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Clayton Gregory Skrzypczak, O.D.
- Title
- Optometrist
- Phone
- (231) 633-8595
Practitioners 7
-
Clayton G Skrzypczak, O.D.
-
Ryan Chrencik, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150506002414 | MI | Part B Supplier - Clinic/Group Practice | 7911226303 |
Receives reassigned benefits from 3 practitioners Practice locations: Kalkaska, MI; Kingsley, MI |
National Provider Directory
Locations
882 M 72 W
Kalkaska, MI 49646
Phone (231) 258-9781
108 E Main St
Kingsley, MI 49649
Phone (231) 263-8172
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 4901004199 | MI | Yes |
Addresses
Primary practice location
882 M 72 NW
Kalkaska, MI 49646-8787
Mailing address
7100 Townline Rd
Kingsley, MI 49649-9623
Other names
- Kalkaska Family Vision Care
Other providers in Kalkaska, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.