Organization
SOUTHERN MICHIGAN ENT P C
Active
Other names
Brookside ENT & Hearing Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G. BIZON M.D. (PRESIDENT)
(269) 979-6444
Entity
Organization
Contact information
Practice address
3600 CAPITAL AVE SW, SUITE 204, BATTLE CREEK, MI 49015-9393
(269) 979-6444
Mailing address
3600 CAPITAL AVE SW, SUITE 204, BATTLE CREEK, MI 49015-9393
(269) 979-6444
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040A310320
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/18/2007
Last updated
04/05/2011
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