Healthcare Provider Details

I. General information

NPI: 1831140367
Provider Name (Legal Business Name): HURLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HURLEY PLZ # ED
FLINT MI
48503-5902
US

IV. Provider business mailing address

1 HURLEY PLZ
FLINT MI
48503-5902
US

V. Phone/Fax

Practice location:
  • Phone: 810-262-9429
  • Fax: 810-262-9104
Mailing address:
  • Phone: 810-262-9255
  • Fax: 810-262-7317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number250040
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number250040
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number250040
License Number StateMI

VIII. Authorized Official

Name: KIMBERLY ECKER
Title or Position: DIRECTOR OF PROFESSIONAL BILLING
Credential:
Phone: 810-257-9952