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General NPI Number Information
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NPI Number | 1538216569
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Entity Type | Organization
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Legal Business Name | VISIONARY MEDICAL SERVICES PC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 100 MICHIGAN ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone | 616-391-1680
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Fax |
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Provider Business Mailing Address
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Address Line | 2536 MOMENTUM PL
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City | CHICAGO
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State | IL
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Zip | 60689-5325
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Country | US
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Telephone | 616-975-1845
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Fax | 616-285-0846
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN THROOP
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Credential | MD
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Telephone | 616-988-8220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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