Provider Demographics
NPI:1942427620
Name:JOHN W STRUTHERS D O P C
Entity Type:Organization
Organization Name:JOHN W STRUTHERS D O P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:STRUTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:313-499-4862
Mailing Address - Street 1:7621 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-9126
Mailing Address - Country:US
Mailing Address - Phone:313-966-2609
Mailing Address - Fax:313-745-0685
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:SUITE 6B, BOX 254
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-966-2609
Practice Address - Fax:313-745-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2915155Medicaid
MIE26177Medicare UPIN
MION87580Medicare ID - Type Unspecified