Organization
KENT OTOLARYNGOLOGY ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS SPOONER MD (PRESIDENT)
(616) 459-7455
Entity
Organization
Contact information
Practice address
222 FULTON ST E, GRAND RAPIDS, MI 49503-3211
(616) 459-7455
Mailing address
222 FULTON ST E, PO BOX 1983, GRAND RAPIDS, MI 49503-3211
(616) 459-7455
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301030445
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1120578
—
MI
Enumeration date
04/26/2007
Last updated
08/22/2020
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