Provider Demographics
NPI:1447676283
Name:BOSWORTH URGENT CARE, PC
Entity type:Organization
Organization Name:BOSWORTH URGENT CARE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-339-2100
Mailing Address - Street 1:1701 LAKE LANSING RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3798
Mailing Address - Country:US
Mailing Address - Phone:517-485-0001
Mailing Address - Fax:
Practice Address - Street 1:1881 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1840
Practice Address - Country:US
Practice Address - Phone:517-339-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOSWORTH URGENT CARE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty