Keego Family Practice

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301069223 Issued in MI

Legal business name

KEEGO FAMILY PRACTICE

Practice address

3435 Orchard Lake Rd
Keego Harbor, MI 48320-1315

Phone

(248) 977-4516

Fax

(248) 977-4549

NPI assigned

Sep 20, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Heather Dickenson

Title

Administrator

Phone

(248) 977-4516

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1891121901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 ORCHARD LAKE RD",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201315",
            "telephone_number": "248-977-4516",
            "fax_number": "248-977-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 ORCHARD LAKE RD",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201315",
            "telephone_number": "248-977-4516",
            "fax_number": "248-977-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEEGO FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "DICKENSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-977-4516",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301069223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin Jenkins Hofmann
• Michelle C Hubert, LMSW
• John Jamnik, D.D.S.
• Richard Jamnik, D.D.S., P.C.
• John F Jamnik D.D.S.,P.C
• Keego Harbor Orthopedic
• Keego Harbor Urgent Care
• Lakeview Family Dental - Keego Harbor
• Lockwood Chiropractic Clinic, PLLC
• Amanda Lockwood, D.C.

• Internal Medicine Physician in Keego Harbor, MI
• Providers in Keego Harbor, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.