Provider Demographics
NPI:1265807333
Name:BRIGHT FUTURE PEDIATRICS P L L C
Entity type:Organization
Organization Name:BRIGHT FUTURE PEDIATRICS P L L C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HYTHAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:FADL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-394-0688
Mailing Address - Street 1:1125 S LINDEN RD STE 500
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-4069
Mailing Address - Country:US
Mailing Address - Phone:810-262-2150
Mailing Address - Fax:810-732-3199
Practice Address - Street 1:1125 S LINDEN RD STE 500
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4069
Practice Address - Country:US
Practice Address - Phone:810-262-2150
Practice Address - Fax:810-732-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty