Healthcare Provider Details
I. General information
NPI: 1659323384
Provider Name (Legal Business Name): HURLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2006
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 ATTN: PROFESSIONAL BILLING DEPT
FLINT MI
48503-5902
US
V. Phone/Fax
- Phone: 810-262-9255
- Fax:
- Phone: 810-262-9255
- Fax: 810-262-7317
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIMBERLY
ECKER
Title or Position: DIRECTOR OF PROFESSIONAL BILLING
Credential:
Phone: 810-262-9952