Hendricks, John C

Hendricks, John C is an individual health care provider with primary practice located at 601 John St Suite M261, Kalamazoo MI 49007-5341. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Hendricks, John C can be contacted via phone (269) 488-2626.

Contact Information

Primary practice address
601 John St Suite M261 Kalamazoo MI 49007-5341
Phone: (269) 488-2626
Fax: (269) 488-2625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 4301033379 Michigan

Profile Details

NPI number 1902849029
LBN Legal business name Hendricks, John C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Dec 15th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902849029 NPPES
Other 107985 GREAT LAKES HLTH PLAN
MEDICAID 4999314 GREAT LAKES HLTH PLAN
Other 5276514 GREAT LAKES HLTH PLAN
Other 1803968251 GREAT LAKES HLTH PLAN
MEDICAID 4238221-10 GREAT LAKES HLTH PLAN

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