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Individual

DR. BRIAN SPENCER GOOSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

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
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
BG001798
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2700022
PHYSICIANS HEALTH PLAN
MI
05
3247656
MI
01
4852310360
BLUE CROSS
MI
Enumeration date
11/03/2006
Last updated
07/08/2007
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