Provider Demographics
NPI:1174918080
Name:JANAS FAMILY MEDICINE PC
Entity type:Organization
Organization Name:JANAS FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:B
Authorized Official - Last Name:JANAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-589-1056
Mailing Address - Street 1:10529 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-9588
Mailing Address - Country:US
Mailing Address - Phone:269-589-1056
Mailing Address - Fax:
Practice Address - Street 1:10529 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-9588
Practice Address - Country:US
Practice Address - Phone:269-589-1056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093533207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty