Provider Demographics
NPI:1396963898
Name:SERVING THROUGH SURGERY PC
Entity type:Organization
Organization Name:SERVING THROUGH SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAIR
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-479-3201
Mailing Address - Street 1:210 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HARBOR BEACH
Mailing Address - State:MI
Mailing Address - Zip Code:48441-1236
Mailing Address - Country:US
Mailing Address - Phone:989-479-3201
Mailing Address - Fax:989-479-5002
Practice Address - Street 1:210 S 1ST ST
Practice Address - Street 2:
Practice Address - City:HARBOR BEACH
Practice Address - State:MI
Practice Address - Zip Code:48441-1236
Practice Address - Country:US
Practice Address - Phone:989-479-3201
Practice Address - Fax:989-479-5019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056501208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN89080001Medicare ID - Type Unspecified
MIF28039Medicare UPIN