Organization
JEANBANC SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUY V JEANBLANC M.D. (PRESIDENT)
(906) 789-1954
Entity
Organization
Contact information
Practice address
3409 LUDINGTON ST, SUITE 206, ESCANABA, MI 49829-4212
(906) 789-1954
(906) 786-5562
Mailing address
3409 LUDINGTON ST, SUITE 206, ESCANABA, MI 49829-4212
(906) 789-1954
(906) 786-5562
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301082854
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4886348
—
MI
01
—
DE8529
RAILROAD MEDICARE
GA
Enumeration date
07/02/2006
Last updated
05/02/2008
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