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General NPI Number Information
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NPI Number | 1770615668
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Entity Type | Organization
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Legal Business Name | PONTIAC OSTEOPATHIC HOSPITAL
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 50 N PERRY ST.
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City | PONTIAC
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State | MI
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Zip | 48342-2253
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Country | US
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Telephone | 832-754-4556
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Fax |
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Provider Business Mailing Address
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Address Line | 2675 BEACON HILL DR 7-206
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City | AUBURN HILLS
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State | MI
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Zip | 48326-3738
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Country | US
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Telephone | 832-754-4556
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Fax |
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Authorized Official
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Title or Position | PGY2 EMERGENCY MEDICINE RESIDENT
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Name | DR. JOHN TRAVIS BENSON
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Credential | D.O.
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Telephone | 832-754-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 5101016621
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License Number State | MI
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