Individual
DR. JOHN W KITZMILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1455 S LAPEER RD STE 200, LAKE ORION, MI 48360-1468
(248) 693-4000
(248) 690-9361
Mailing address
1455 S LAPEER RD STE 200, LAKE ORION, MI 48360-1468
(248) 693-4000
(248) 690-9361
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301006731
MI
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
4301036695
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0606301871
BCBS
—
05
—
1518393800
—
MI
05
—
1811988504
—
MI
Enumeration date
11/02/2005
Last updated
03/05/2025
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