Organization
DOUGLAS J GENTRY MD PLLC
Active
Other names
DOUGLAS J GENTRY MD PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS JAMES GENTRY MD (OWNER)
(231) 845-0600
Entity
Organization
Contact information
Practice address
250 NELSON RD, STE 2, LUDINGTON, MI 49431-1993
(231) 845-0600
(231) 845-6030
Mailing address
250 NELSON RD, STE 2, LUDINGTON, MI 49431-1993
(231) 845-0600
(231) 845-6030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301076105
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0531024
BUE CROSS BLUE SHIELD
MI
05
—
4522344
—
MI
Enumeration date
04/19/2007
Last updated
02/01/2008
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