Provider Demographics
NPI:1407980246
Name:MID-MICHIGAN GASTROENTEROLOGY CONSULTANTS PC
Entity type:Organization
Organization Name:MID-MICHIGAN GASTROENTEROLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:SCHACHINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-783-3112
Mailing Address - Street 1:2424 SPRING ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-2748
Mailing Address - Country:US
Mailing Address - Phone:517-783-3112
Mailing Address - Fax:517-783-6057
Practice Address - Street 1:2424 SPRING ARBOR RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-2748
Practice Address - Country:US
Practice Address - Phone:517-783-3112
Practice Address - Fax:517-783-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI010043207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200000004876OtherPHP
MI1053808245OtherBCBSM
MI3216444Medicaid
100008017OtherRR MEDICARE
0P21470Medicare ID - Type Unspecified
MI3216444Medicaid