1265525588 NPI number — ADVANCED ORTHOPEDIC SOLUTIONS, P.C.

Table of content: (NPI 1265525588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265525588 NPI number — ADVANCED ORTHOPEDIC SOLUTIONS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ORTHOPEDIC SOLUTIONS, 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:
1265525588
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2240 E. HILL RD
Provider Second Line Business Mailing Address:
STE H
Provider Business Mailing Address City Name:
GRAND BLANC
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48439-5425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-606-8766
Provider Business Mailing Address Fax Number:
810-606-8770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2240 E. HILL RD
Provider Second Line Business Practice Location Address:
STE H
Provider Business Practice Location Address City Name:
GRAND BLANC
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48439-5425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-606-8766
Provider Business Practice Location Address Fax Number:
810-606-8770
Provider Enumeration Date:
09/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DOWLING
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
WILLIAM
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
810-606-8766

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  5501006953 , 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: 0B51900 . This is a "BCBSM" identifier . This identifiers is of the category "OTHER".




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