Organization
GERIATRIC PHYSICIAN STAFFING, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ANN O'SULLIVAN M.D. (OWNER)
(231) 838-2765
Entity
Organization
Contact information
Practice address
1513 N ORCHARD DR, TRAVERSE CITY, MI 49686-1946
(231) 838-2765
Mailing address
1513 N ORCHARD DR, TRAVERSE CITY, MI 49686-1946
(231) 838-2765
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
4301081068
MI
Other
Enumeration date
05/16/2006
Last updated
09/21/2007
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