Individual
DR. JEFFREY ELLIOTT KITTLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
148 PARKDALE AVE, MANISTEE, MI 49660-1128
(231) 723-1190
(231) 723-1467
Mailing address
148 PARKDALE AVE, MANISTEE, MI 49660-1128
(231) 723-1190
(231) 723-1467
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301054168
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0805100161
BCBS
MI
05
—
4473731
—
MI
Enumeration date
06/22/2005
Last updated
07/08/2007
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