Kitzmiller, John W
Kitzmiller, John W is an sole proprietor health care provider with primary practice located at 1375 S Lapeer Rd Ste 203 , Lake Orion MI 48360-1421. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Kitzmiller, John W can be contacted via phone (248) 693-4000.Contact Information
Primary practice address
1375 S Lapeer Rd Ste 203
Lake Orion MI 48360-1421
Phone: (248) 693-4000
Fax: (248) 693-4661
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301014619 | Michigan |
Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 4301036695 | Michigan |
Profile Details
NPI number | 1811988504 |
---|---|
LBN Legal business name | Kitzmiller, John W |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 2nd, 2005 |
Last updated | Mar 28th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1811988504 | NPPES |
Other | 0606301871 | BCBS | |
MEDICAID | 101521316 | BCBS | |
MEDICAID | 1720134943 | BCBS |
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