Provider Demographics
NPI:1548257256
Name:BAY POINT FAMILY CARE, PLLC
Entity type:Organization
Organization Name:BAY POINT FAMILY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-935-0695
Mailing Address - Street 1:1105 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2926
Mailing Address - Country:US
Mailing Address - Phone:231-935-0695
Mailing Address - Fax:231-935-0699
Practice Address - Street 1:1105 E FRONT ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2926
Practice Address - Country:US
Practice Address - Phone:231-935-0695
Practice Address - Fax:231-935-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4438616Medicaid
MI4438625Medicaid
MIF00562Medicare UPIN
0N58210Medicare ID - Type Unspecified
MI4438616Medicaid