# MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

> 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
- **Other names:** OMH Medical Group - Lewiston, Munson Healthcare OMH Medical Group-Lewiston
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538328364
- **Authorized official:** MR. THOMAS R. LEMON (CEO)
- **Authorized official phone:** (989) 731-2230

## Contact information

- **Practice address:** 3040 BOURN ST, LEWISTON, MI 49756
- **Practice address phone:** (989) 786-4877
- **Practice address fax:** (989) 786-2187
- **Mailing address:** 829 N CENTER AVE, GAYLORD, MI 49735-1595
- **Mailing address phone:** (989) 731-7777
- **Mailing address fax:** (989) 731-7776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 690020 | MI | Yes |

## Other

- **Enumeration date:** 06/06/2008
- **Last updated:** 08/22/2018