# MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OTSEGO MEMORIAL HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427064054
- **Legal business name:** OTSEGO MEMORIAL HOSPITAL
- **Authorized official:** MR. KEVIN WAHR CRO (CHIEF REVENUE OFFICER)
- **Authorized official phone:** (989) 731-7777

## Contact information

- **Practice address:** 829 N CENTER AVE, SUITE 160, GAYLORD, MI 49735
- **Practice address phone:** (989) 732-7131
- **Mailing address:** 829 N CENTER AVE, GAYLORD, MI 49735-1595
- **Mailing address phone:** (989) 731-7708
- **Mailing address fax:** (989) 731-7929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 08/22/2018