Healthcare Provider Details

I. General information

NPI: 1467236364
Provider Name (Legal Business Name): ANTHONY JAMES HOHOLIK PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 32 AVE 4700 32 AVE
HUDSONVILLE MI
49426
US

IV. Provider business mailing address

4700 32 AVE
HUDSONVILLE MI
49426
US

V. Phone/Fax

Practice location:
  • Phone: 616-662-2011
  • Fax: 616-662-2222
Mailing address:
  • Phone: 616-662-2011
  • Fax: 616-662-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601011989
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56010111989
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: