Healthcare Provider Details

I. General information

NPI: 1700058146
Provider Name (Legal Business Name): HURLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HURLEY PLZ
FLINT MI
48503-5902
US

IV. Provider business mailing address

1 HURLEY PLZ
FLINT MI
48503-5902
US

V. Phone/Fax

Practice location:
  • Phone: 810-262-9255
  • Fax:
Mailing address:
  • Phone: 810-262-9255
  • Fax: 810-262-7317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: KIMBERLY ECKER
Title or Position: DIRECTOR OF PROFESSIONAL BILLING
Credential:
Phone: 810-262-9952