Provider Demographics
NPI:1376159491
Name:HEALOX HEALTH PLLC
Entity Type:Organization
Organization Name:HEALOX HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-523-5194
Mailing Address - Street 1:29984 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1355
Mailing Address - Country:US
Mailing Address - Phone:810-523-5194
Mailing Address - Fax:248-480-0501
Practice Address - Street 1:29201 TELEGRAPH RD STE 200
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7645
Practice Address - Country:US
Practice Address - Phone:810-523-5194
Practice Address - Fax:248-480-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty