Michael J. Bacon, D.O.
Individual provider Active NPI Family Medicine Physician · Petoskey, MI
NPI 1912965799 · NPPES record last updated May 6, 2014
Key facts
- NPI
- 1912965799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101006585 (MI)
- Practice address
- 1937 M 119
Petoskey, MI 49770-8913 - Phone
- (231) 348-9200
- Fax
- (231) 348-9876
- NPI assigned
- May 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alpine Cardiology, PLLC | Past |
Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/23627/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101006585 | MI | Yes |
Addresses
Primary practice location
1937 M 119
Petoskey, MI 49770-8913
Mailing address
1937 M 119
Petoskey, MI 49770-8913
Phone (231) 348-9200
Other providers in Petoskey, MI
- Khalil A Attie
- Brittany Averill
- Jenniffer Azolas
- Chelsea J Bachelor
- Jill Bacigalupi
- Karen Ferguson Bagwell
- Aleece R Balchik
- Rita Nichole Balistreri
- Michael Duane Banyai
- Tyrone Anthony Barbee
All providers in Petoskey, MI · Family 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 May 6, 2014. 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.