GEORGETOWN MEDICAL CENTER LLC NPI 1427170414

NPI Information

  • NPI: 1427170414
  • Provider Name: GEORGETOWN MEDICAL CENTER LLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 670 BALDWIN ST
    JENISON, MI
    ZIP 49428
  • Phone: (616) 457-4610

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NPI Details

GEORGETOWN MEDICAL CENTER LLC is a general practice in Jenison, 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 GEORGETOWN MEDICAL CENTER LLC NPI is 1427170414. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

670 BALDWIN ST
JENISON, MI
ZIP 49428-757
Phone: (616) 457-4610
Fax: (616) 457-8750

The provider's authorized official is Jay Lugthart .
The authorized official title is President and has the following contact phone number (616) 457-4610.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 5/24/2012.

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
1208600000XSurgeryNo
2208D00000XGeneral PracticeYes

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
1700D160370OTHERBCBS
20D16037MEDICARE PINMICHIGAN

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: 3/30/2025

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