Individual
PAYTON JON KOOIKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 MICHIGAN ST NE STE A601, GRAND RAPIDS, MI 49503-2560
(616) 391-6243
Mailing address
400 LEE ST N, LEWISBURG, WV 24901-1274
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5151016750
MI
Other
Enumeration date
03/16/2023
Last updated
05/13/2025
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