1306078415 NPI number — JOHN H. FINLEY D.O. & ASSOC P.C.

Table of content: (NPI 1306078415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306078415 NPI number — JOHN H. FINLEY D.O. & ASSOC P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN H. FINLEY D.O. & ASSOC P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306078415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 266
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48037-0266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-642-5444
Provider Business Mailing Address Fax Number:
248-642-5447

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29877 TELEGRAPH RD
Provider Second Line Business Practice Location Address:
SUITE 304
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48034-1332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-642-5444
Provider Business Practice Location Address Fax Number:
248-642-5447
Provider Enumeration Date:
08/23/2009

Additional Information

Authorized Official

Authorized Official Last Name:
FINLEY
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
H.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
248-642-5444

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  JF004222 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9630021 . This is a "BLUE CROSS BLUE SHIELD OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1140955 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com