Provider Demographics
NPI:1265459150
Name:GREATER FLINT SPORTS MEDICINE CENTER PC
Entity Type:Organization
Organization Name:GREATER FLINT SPORTS MEDICINE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:HEMING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-953-0500
Mailing Address - Street 1:861 HEALTH PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7383
Mailing Address - Country:US
Mailing Address - Phone:810-953-0500
Mailing Address - Fax:810-953-0031
Practice Address - Street 1:861 HEALTH PARK BLVD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439
Practice Address - Country:US
Practice Address - Phone:810-953-0500
Practice Address - Fax:810-953-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207X00000X
MI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30610OtherBLUE CROSS PHYS THERAPY
MI200B547370OtherBLUE CROSS
MI200B547370OtherBLUE CROSS
MI6333330001Medicare NSC