Provider Demographics
NPI:1952377350
Name:HPCN/NORTON FAMILY PRACTICE
Entity Type:Organization
Organization Name:HPCN/NORTON FAMILY PRACTICE
Other - Org Name:NORTON FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-728-1678
Mailing Address - Street 1:3535 PARK ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3736
Mailing Address - Country:US
Mailing Address - Phone:231-733-3155
Mailing Address - Fax:231-733-0739
Practice Address - Street 1:3535 PARK ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-3736
Practice Address - Country:US
Practice Address - Phone:231-733-3155
Practice Address - Fax:231-733-0739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA700F11095OtherBLUE CROSS BLUE SHIELD
MA700F11095OtherBLUE CARE NETWORK
MA700F11095OtherBLUE CARE NETWORK
MA=========004OtherTRICARE