Organization
GREAT LAKES UROGYNECOLOGY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACLYN TAYLOR BARATONO (AUTHORIZED OFFICIAL)
(734) 225-6859
Entity
Organization
Contact information
Practice address
19249 ALLEN RD STE B, BROWNSTOWN TWP, MI 48183-1189
(248) 835-2797
Mailing address
19249 ALLEN RD STE B, BROWNSTOWN TWP, MI 48183-1189
(734) 225-6859
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
—
—
Other
Enumeration date
07/10/2025
Last updated
08/05/2025
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