MEDICARE: DR. JON D HOP M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	4301072024	MI
2	207X00000X	Orthopaedic Surgery Physician	JH072024	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P94459	OTHER	MI	BLUE CARE NETWORK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	JH072024	OTHER	MI	STATE LICENSE
4	5637634	OTHER	MI	AETNA

General Provider Information

NPI Number	:	1164422218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON D HOP M.D.

Provider Business Mailing Address
First Line	:	370 120TH AVE
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49424-2196
Country	:	US
Telephone Number	:	616-396-5855
Fax Number	:	616-396-5720

Provider Business Practice Location Address
First Line	:	370 120TH AVE
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49424
Country	:	US
Telephone Number	:	616-396-5855
Fax Number	:	616-396-5720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/30/2018

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Directions to “ DR. JON D HOP M.D.” Practice Location

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