1326436817 NPI number — FAMILY ORTHOPEDIC ASSOCIATES P L C

Table of content: (NPI 1326436817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326436817 NPI number — FAMILY ORTHOPEDIC ASSOCIATES P L C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY ORTHOPEDIC ASSOCIATES P L 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:
ORTHOMICHIGAN/ORTHOMICHIGAN NOW/ORTHOMICHIGAN THERAPY SERVICES
Provider Other Organization Name Type Code:
3
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:
1326436817
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4466 W BRISTOL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48507-3170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-733-1200
Provider Business Mailing Address Fax Number:
810-733-3130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4466 W BRISTOL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48507-3170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-733-1200
Provider Business Practice Location Address Fax Number:
810-733-3130
Provider Enumeration Date:
01/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KELSEY
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
810-733-1200

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2081P2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com