# MECOSTA COUNTY MEDICAL CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366725954
- **Authorized official:** MR. THOMAS S DAUGHERTY (CEO)
- **Authorized official phone:** (231) 592-4205

## Contact information

- **Practice address:** 605 OAK ST, BIG RAPIDS, MI 49307-2048
- **Practice address phone:** (231) 796-8691
- **Practice address fax:** (231) 592-4494
- **Mailing address:** 605 OAK ST, BIG RAPIDS, MI 49307-2048
- **Mailing address phone:** (231) 796-8691
- **Mailing address fax:** (231) 592-4494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 540030 | MI | Yes |

## Other

- **Enumeration date:** 09/21/2011
- **Last updated:** 09/21/2011