# MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Munson Healthcare OMH Medical Group-Indian River, OMH Medical Group - Indian River
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053661231
- **Authorized official:** MRS. ELLEN O SMITH (CEO)
- **Authorized official phone:** (989) 731-2230

## Contact information

- **Practice address:** 3860 S STRAITS HWY, INDIAN RIVER, MI 49749
- **Practice address phone:** (231) 238-0581
- **Practice address fax:** (231) 238-0856
- **Mailing address:** 271 MCCOY RD W, GAYLORD, MI 49735-8253
- **Mailing address phone:** (989) 731-7777
- **Mailing address fax:** (989) 731-7776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | MI | Yes |

## Other

- **Enumeration date:** 09/14/2012
- **Last updated:** 10/18/2022