Organization
DELTA FOOT CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN SPENCER GOOSEN DPM (OWNER)
(517) 485-7300
Entity
Organization
Contact information
Practice address
3802 W KALAMAZOO ST, LANSING, MI 48917-3653
(517) 485-7300
(517) 485-7301
Mailing address
3802 W KALAMAZOO ST, LANSING, MI 48917-3653
(517) 485-7300
(517) 485-7301
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
BG001798
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P00920
MEDICARE SECONDARY PAYOR
MI
01
—
17738
PRIORITY HEALTH
MI
01
—
201749
MEDICAID MCLAREN
MI
01
—
480B310270
BLUE CARE NETWORK
MI
Enumeration date
02/05/2007
Last updated
04/21/2009
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