Healthcare Provider Details

I. General information

NPI: 1669418356
Provider Name (Legal Business Name): RUDY C OCHS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E MAIN ST
HART MI
49420
US

IV. Provider business mailing address

PO BOX 1848
MUSKEGON MI
49443-1848
US

V. Phone/Fax

Practice location:
  • Phone: 231-873-5675
  • Fax: 231-873-1825
Mailing address:
  • Phone: 231-727-5211
  • Fax: 231-727-4571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101009698
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: