Provider Demographics
NPI:1780239632
Name:CURRY FAMILY MEDICINE, PLLC
Entity type:Organization
Organization Name:CURRY FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:612-385-8041
Mailing Address - Street 1:2511 ROCKHILL DR NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-1240
Mailing Address - Country:US
Mailing Address - Phone:612-385-8041
Mailing Address - Fax:
Practice Address - Street 1:5258 PLAINFIELD AVE NE STE F
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1092
Practice Address - Country:US
Practice Address - Phone:616-729-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1649438748Medicaid