Organization
LIGHTHOUSE FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. G. BLAIR DOWDEN M.D. (MEDICAL DOCTOR)
(810) 824-4222
Entity
Organization
Contact information
Practice address
4071 24TH AVE, FORT GRATIOT, MI 48059-3801
(810) 824-4222
(810) 824-4220
Mailing address
4071 24TH AVE, FORT GRATIOT, MI 48059-3801
(810) 824-4222
(810) 824-4220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301088847
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750379194
—
MI
Enumeration date
01/25/2011
Last updated
01/25/2011
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