MEDICARE: HPCN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1932113388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HPCN

Provider Business Mailing Address
First Line	:	PO BOX 1148
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49443-1148
Country	:	US
Telephone Number	:	231-727-4444
Fax Number	:	231-727-4451

Provider Business Practice Location Address
First Line	:	1909 RUDDIMAN DR
Second Line	:
City	:	NORTH MUSKEGON
State	:	MI
Zip	:	49445-3147
Country	:	US
Telephone Number	:	231-744-5577
Fax Number	:	231-744-8777

Authorized Official
Title or Position	:	SENIOR DIRECTOR NETWORK ADMIN
Name	:	THOMAS REYNOLDS
Credential	:
Telephone Number	:	231-672-6740

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	01/06/2009

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Directions to “HPCN ” Practice Location

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