Provider Demographics
NPI:1346227626
Name:EMERGENCY MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:EMERGENCY MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-337-0957
Mailing Address - Street 1:PO BOX 634280
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-4280
Mailing Address - Country:US
Mailing Address - Phone:517-337-0957
Mailing Address - Fax:517-336-9122
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48909
Practice Address - Country:US
Practice Address - Phone:517-336-8080
Practice Address - Fax:517-336-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI010C376260OtherBLUE CROSS BLUE SHIELD
MI1003128OtherMCLAREN
MI0C37626OtherBLUE CROSS BLUE SHIELD
MICK0330OtherRAILROAD MEDICARE
MICK0330Medicare PIN
MI010C376260OtherBLUE CROSS BLUE SHIELD
MICK0330OtherRAILROAD MEDICARE
MI1003128OtherMCLAREN