Provider Demographics
NPI:1720118243
Name:SOUTHWEST MICHIGAN ONCOLOGY ASSOCIATES PLLC
Entity type:Organization
Organization Name:SOUTHWEST MICHIGAN ONCOLOGY ASSOCIATES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER OF LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-969-6187
Mailing Address - Street 1:300 NORTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017
Mailing Address - Country:US
Mailing Address - Phone:269-969-6187
Mailing Address - Fax:269-966-8639
Practice Address - Street 1:300 NORTH AVENUE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017
Practice Address - Country:US
Practice Address - Phone:269-969-6187
Practice Address - Fax:269-966-8639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N75730Medicare PIN