Pennock Hospital Board of Trustees
Organization Active NPI Family Medicine Physician · Hastings, MI
NPI 1508225632 · NPPES record last updated Feb 17, 2016
Key facts
- NPI
- 1508225632
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PENNOCK HOSPITAL BOARD OF TRUSTEES
- Practice address
- 1108 W State St
Hastings, MI 49058-9711 - Phone
- (269) 945-8080
- NPI assigned
- Feb 17, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- PENNOCK HOSPITAL BOARD OF TRUSTEES
Authorized official
- Name
- Robert Davis
- Title
- VP Physician Network
- Phone
- (269) 945-1220
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Deborah a Joseph DO
- Part of
- Deborah a Joseph DO
Locations
1108 W State St
Hastings, MI 49058
Phone (269) 945-8080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1108 W State St
Hastings, MI 49058-9711
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Other providers in Hastings, MI
- Pennock Hospital
- Pennock Hospital
- Pennock Hospital
- Pennock Hospital
- Pennock Hospital Board of Trustees
- Pennock Hospital Board of Trustees
- Pennock Pharmacy, Inc.
- Pennock State Street Center
- Carmen Perry
- Tami Lynn Pettenger
All providers in Hastings, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.