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Individual

AMY B JENTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
550 E WASHINGTON ST, IONIA, MI 48846-2202
(616) 523-1630
(616) 523-1631
Mailing address
550 E WASHINGTON ST, IONIA, MI 48846-2202
(616) 522-0714
(616) 522-0456

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301076427
MI
208600000X
Surgery Physician
Primary
AJ076427
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03004
PRIORITY HEALTH PAY TO #
MI
01
1016881
MCLAREN
MI
05
104791262
MI
01
200000002169
PHPMM
MI
01
383218134
TRICARE
MI
01
4791262
MOLINA
MI
01
700C460060
BCBS OF MI GROUP
MI
Enumeration date
08/20/2006
Last updated
08/12/2026
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