Individual
DR. JOHN K EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6135 CRESSY ST, INDIAN RIVER, MI 49749
(231) 238-8908
(231) 238-4419
Mailing address
1035 W WASHINGTON AVE, ALPENA, MI 49707-2929
(989) 736-9815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101010086
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0151600015
INDIVIDUAL BLUE CROSS
MI
05
—
2800120
—
MI
01
—
700A610050
GROUP BLUE CROSS
MI
Enumeration date
07/10/2006
Last updated
02/02/2021
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