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FENTON LATE HOURS CLINIC NPI 1619131646


NPI Information

NPI: 1619131646
Provider Name: FENTON LATE HOURS CLINIC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
102 N ADELAIDE ST
FENTON, MI
ZIP 48430
Phone: (810) 629-7511
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FENTON LATE HOURS CLINIC is a clinic center in Fenton, MI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FENTON LATE HOURS CLINIC NPI is 1619131646. The provider is registered as an organization entity type.

The provider's business location address is:

102 N ADELAIDE ST
FENTON, MI
ZIP 48430-670
Phone: (810) 629-7511
Fax: (810) 629-6535

The provider's authorized official is Deborah L Duncan .
The authorized official title is Physician/co Owner and has the following contact phone number (810) 629-7511.

The enumeration date for this NPI number is 7/18/2008 and was last updated on 7/18/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center4301051746MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1700B512020OTHERMICHIGANBLUE CARE NETWORK ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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