Provider Demographics
NPI:1104094275
Name:MID-MICHIGAN ORTHOPAEDICS
Entity type:Organization
Organization Name:MID-MICHIGAN ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:PALAZETI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-725-6101
Mailing Address - Street 1:113 E WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2360
Mailing Address - Country:US
Mailing Address - Phone:989-725-6101
Mailing Address - Fax:989-723-3601
Practice Address - Street 1:1000 E STURGIS ST
Practice Address - Street 2:SUITE 9
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2068
Practice Address - Country:US
Practice Address - Phone:989-227-1371
Practice Address - Fax:989-224-3824
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID-MICHIGAN ORTHOPAEDICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-12
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0550210005Medicare NSC