Organization
GAYLORD FAMILY PRACTICE ASSOCIATES PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L LINGAUR MD (CEO)
(989) 731-5092
Entity
Organization
Contact information
Practice address
1320 E M 32, GAYLORD, MI 49735-8378
(989) 731-5092
(989) 731-7639
Mailing address
PO BOX 2219, GAYLORD, MI 49734-2219
(989) 731-5092
(989) 731-7639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080F910050
BLUE CROSS BLUE SHIELD
MI
Enumeration date
02/27/2006
Last updated
04/29/2010
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