Georgetown Medical Center LLC

NPI #1427170414 in Jenison, Michigan

Provider Information

NPI Number: 1427170414
Entity Type: Organization
Organization Name: Georgetown Medical Center LLC
Primary Specialty: General Practice
Enumeration Date: Apr 3, 2007
Last Updated: May 24, 2012

Practice Location

Address: 670 BALDWIN ST
City: Jenison
State: Michigan
ZIP Code: 49428-9757
Phone: (616) 457-4610

Authorized Official

Name: DR. JAY LUGTHART, M.D.
Title: PRESIDENT
Phone: (616) 457-4610

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X
General Practice	208D00000X	Primary

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