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General NPI Number Information
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NPI Number | 1578509303
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Entity Type | Individual
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Provider Name | JOHN H HEALEY JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 2373 64TH ST SW
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City | BYRON CENTER
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State | MI
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Zip | 49315-7974
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Country | US
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Telephone | 616-496-5591
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Fax | 616-465-5911
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Provider Business Mailing Address
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Address Line | PO BOX 776974
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City | CHICAGO
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State | IL
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Zip | 60677-6974
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 4301059802
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License Number State | MI
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