KSK MEDICAL PLLC NPI 1043832801

NPI Information

NPI: 1043832801
Provider Name: KSK MEDICAL PLLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
6300 WINTER RD
MANITOU BEACH, MI
ZIP 49253
Phone: (517) 306-2244
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KSK MEDICAL PLLC is a general practice in Manitou Beach, MI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee KSK MEDICAL PLLC NPI is 1043832801. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6300 WINTER RD
MANITOU BEACH, MI
ZIP 49253-634
Phone: (517) 306-2244
Fax: (866) 465-0269

The provider's authorized official is Robyn M Jones .
The authorized official title is Business Manager and has the following contact phone number (517) 306-2244.

The enumeration date for this NPI number is 5/14/2020 and was last updated on 5/14/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2426860	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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