Provider Demographics
NPI:1457387201
Name:HURLEY MEDICAL CENTER
Entity Type:Organization
Organization Name:HURLEY MEDICAL CENTER
Other - Org Name:HURLEY CLINICAL PSYCHIARTISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PROFESSIONAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-257-9952
Mailing Address - Street 1:1 HURLEY PLZ
Mailing Address - Street 2:ATTN PROFESSIONAL BILLING
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5902
Mailing Address - Country:US
Mailing Address - Phone:810-262-9255
Mailing Address - Fax:810-262-7317
Practice Address - Street 1:1085 S LINDEN RD STE 150
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532
Practice Address - Country:US
Practice Address - Phone:810-262-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HURLEY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-23
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2500402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B57747OtherBLUE SHIELD
MI750910736OtherBS OPC
MI0M10100Medicare ID - Type UnspecifiedPSYCHIATRIST