Kevin E Till Dpm Pc

LBN: Kevin E Till Dpm Pc
Kevin E Till Dpm Pc is an health care organization with primary practice located at 4160 John R St Ste 1012, Detroit MI 48201-2020. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Kevin E Till Dpm Pc can be contacted via phone (313) 831-6442, or through Till, Kevin E via phone (313) 831-6442.

Contact Information

Primary practice address
4160 John R St Ste 1012 Detroit MI 48201-2020
Phone: (313) 831-6442
Fax: (313) 831-6513
Website:
Map and Directions
Authorized official contact:
Name: Till, Kevin E Doctor of Podiatric Medicine (DPM)
Phone: (313) 831-6442

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 5901001067 Michigan

Profile Details

NPI number 1164592820
LBN Legal business name Kevin E Till Dpm Pc
DBA Doing business as
Authorized official Till, Kevin E Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 9th, 2006
Last updated Dec 29th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164592820 NPPES
Michigan MEDICAID 133113886

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