Organization
ELLA E M BROWN CHARITABLE CIRCLE
Active
Other names
Oaklawn Medical Group Homer
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG BEEG (PRESIDENT & CEO)
(269) 781-4271
Entity
Organization
Contact information
Practice address
420 S HILLSDALE ST, HOMER, MI 49245-1248
(517) 568-4481
(517) 568-3720
Mailing address
200 N MADISON ST, MARSHALL, MI 49068-1143
(269) 781-4271
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103118050
—
MI
01
—
16004
BCBS OF MICHIGAN FACILITY PIN
MI
Enumeration date
01/09/2007
Last updated
12/07/2021
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