Provider Demographics
NPI:1013073741
Name:MIDWEST THORACIC SURGEONS, PC
Entity Type:Organization
Organization Name:MIDWEST THORACIC SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-551-0669
Mailing Address - Street 1:3577 WEST THIRTEEN MILE RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073
Mailing Address - Country:US
Mailing Address - Phone:248-551-0669
Mailing Address - Fax:248-551-0058
Practice Address - Street 1:3577 WEST THIRTEEN MILE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-551-0669
Practice Address - Fax:248-551-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty