Organization
CLARKSTON HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI K THOMAS R.T. (MANAGER)
(248) 620-4227
Entity
Organization
Contact information
Practice address
5625 WATER TOWER PL, SUITE G-33, CLARKSTON, MI 48346-2671
(248) 620-4222
(248) 620-4234
Mailing address
5625 WATER TOWER PL, SUITE G-33, CLARKSTON, MI 48346-2671
(248) 620-4222
(248) 620-4234
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
775305
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000009522
CAPE MEDICAL
MI
01
—
0996948
HEALTH PLUS OF MI
MI
01
—
137850
CARE CHOICES
MI
01
—
16442
M-CARE
MI
01
—
7065650
CIGNA
MI
01
—
OF30168
BLUE CARE NETWORK
MI
01
—
ON75750
HAP
MI
Enumeration date
06/20/2006
Last updated
08/22/2020
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