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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811988504 NPPES
Other 0606301871 BCBS
MEDICAID 101521316 BCBS
MEDICAID 1720134943 BCBS

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