Provider Demographics
NPI:1154155695
Name:PARAGON HEALTH PC
Entity type:Organization
Organization Name:PARAGON HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTILING
Authorized Official - Prefix:
Authorized Official - First Name:KATHY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:UECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-420-9404
Mailing Address - Street 1:6938 ELM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-7436
Mailing Address - Country:US
Mailing Address - Phone:269-364-6865
Mailing Address - Fax:269-381-3063
Practice Address - Street 1:6938 ELM VALLEY DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-7436
Practice Address - Country:US
Practice Address - Phone:269-364-6865
Practice Address - Fax:269-381-3063
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAGON HEALTH PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty