Jeffrey Jay Kiel, DO
Individual provider Active NPI Internal Medicine Physician · Indian River, MI
NPI 1720071657 · NPPES record last updated Mar 1, 2023
Key facts
- NPI
- 1720071657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- JK010369 (MI)
- Practice address
- 2030 S Straits Hwy
Indian River, MI 49749-9792 - Phone
- (231) 649-0935
- NPI assigned
- Aug 25, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
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, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JK010369 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Memorial Hospital | Internal Medicine | Past | Accepting new patients |
| Northwoods Ear, Nose & Throat PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | JK010369 | MI | Yes |
Addresses
Primary practice location
2030 S Straits Hwy
Indian River, MI 49749-9792
Mailing address
2030 S Straits Hwy
Indian River, MI 49749-9792
Phone (231) 649-0935
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11-4435122 | Medicaid | MI |
Other providers in Indian River, MI
- Kane RX Inc
- Kerri Anne Katona
- Michael D Katona
- Tammy Sue Kauffman
- Robert Clair Kenny
- Seth William King
- Katherine Klose
- Julie Kolly
- Marcia Margaret Kosovec
- Janet Marie Ladere
All providers in Indian River, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.