Healthcare Provider Details

I. General information

NPI: 1912672544
Provider Name (Legal Business Name): JON STUDINGER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 WASHINGTON AVE STE 150
HOLLAND MI
49423-7147
US

IV. Provider business mailing address

854 WASHINGTON AVE STE 150
HOLLAND MI
49423-7147
US

V. Phone/Fax

Practice location:
  • Phone: 616-395-2853
  • Fax:
Mailing address:
  • Phone: 616-395-2853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: