DR. KEVIN L GIETZEN (NPI# 1538189154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538189154 |
| Entity Type | Individual |
| Full Name | DR. KEVIN L GIETZEN |
| Credential | D.O. |
| Practice Address |
560 W Mitchell St Suite 250 Petoskey MI 49770-2275 |
| Practice Telephone | 2314873277 |
| Practice Fax Number | 2314876167 |
| Mailing Telephone | 2314873277 |
| Mailing Fax Number | 2314876167 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
5101013761 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4523065 | 05 | |
| MI | BLUE CROSS BLUE SHIELD | 0452410245 | 01 |
| Street Address |
560 W MITCHELL ST SUITE 250 |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-2275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437156940 | Melanie S Manary | Internal Medicine | 560 W Mitchell St, Ste 300, Petoskey, MI 49770-2278 | 2005-06-30 |
| 1346862455 | Mclaren Central Michigan | Clinic/Center | 560 W Mitchell St, Petoskey, MI 49770-2275 | 2020-05-12 |
| 1841732617 | Dawn Ebersole | Nurse Practitioner | 560 W Mitchell St, Suite M40, Petoskey, MI 49770-2275 | 2016-11-10 |
| 1689025363 | Kasey Peltier | Nurse Practitioner | 560 W Mitchell St, Suite 505, Petoskey, MI 49770-2275 | 2016-06-24 |
| 1912390741 | Twin Oaks Mental Health Center, LLC | Clinic/Center | 560 W Mitchell St, Suite 208, Petoskey, MI 49770-2275 | 2015-03-18 |
| 1053728840 | Kristi Lynn Dipzinski | Nurse Practitioner | 560 W Mitchell St, Suite 300, Petoskey, MI 49770-2275 | 2014-07-14 |
| 1609281401 | Cale M Sebald | Internal Medicine | 560 W Mitchell St, Petoskey, MI 49770-2275 | 2014-07-01 |
| 1942629530 | Robin Brooks | Audiologist | 560 W Mitchell St, Petoskey, MI 49770-2275 | 2014-04-10 |
| 1295074128 | Lindsay Ann Potts | Physician Assistant | 560 W Mitchell St, Suite 505, Petoskey, MI 49770-2275 | 2013-02-13 |
| 1720327695 | Harbor Neurology Plc | Psychiatry & Neurology | 560 W Mitchell St, Suite 350, Petoskey, MI 49770-2275 | 2013-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
| 1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
| 1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
| 1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
| 1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
| 1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
| 1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
| 1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
| 1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
| 1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
| Find all providers in zip 49770 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942497466 | James Jonathan Slater | Otolaryngology | 2611 Charlevoix Ave, Petoskey, MI 49770-8524 | 2007-09-28 |
| 1316965767 | Petoskey Ear Nose & Throat Specialists Pllc | Otolaryngology | 560 W Mitchell St, Suite 250, Petoskey, MI 49770-2275 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851720312 | Prasad J Thottam | Otolaryngology | 7001 Ochard Lake Road, 320c, West Bloomfield, MI 48322-3607 | 2013-11-05 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| 1336362722 | Danny Kewson M.d. P.c | Otolaryngology | 2454 Monroe St Ste A, Dearborn, MI 48124 | 2007-04-11 |
| 1528145935 | Demello Medical Clinic | Otolaryngology | 39379 Garfield Rd, Cilnton Township, MI 48038 | 2006-11-01 |
| 1508979436 | Russell Wayne Craig | Otolaryngology | 17901 Hall Rd, Macomb Twp, MI 48044 | 2006-08-16 |
| 1942218177 | Paul E Lomeo | Otolaryngology | 268 W Seminole Rd, Muskegon, MI 49444-3733 | 2006-08-03 |
| 1891715991 | Phillips H Winter | Otolaryngology | 577 Michigan Avenue, Suite 101, Holland, MI 49423 | 2006-07-20 |
| 1336191139 | Robert Louis Borenitsch | Otolaryngology | 5200 State St, Saginaw, MI 48603-3713 | 2006-05-17 |
| 1124007539 | Ted H Schwartzenfeld | Otolaryngology | 27483 Dequindre Rd Ste 201, Madison Heights, MI 48071-5711 | 2006-01-13 |
| 1851390066 | Michael Andrew Freedman | Otolaryngology | 14600 King Rd Ste D, Riverview, MI 48193-7952 | 2005-07-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.