Basic Information
| Provider Information | |||||||||
| NPI: | 1386665289 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HASTINGS SURGEONS, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 W GREEN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | HASTINGS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490581712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699488411 | ||||||||
| FaxNumber: | 2699489874 | ||||||||
| Practice Location | |||||||||
| Address1: | 1005 W GREEN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | HASTINGS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490581712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699488411 | ||||||||
| FaxNumber: | 2699489874 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RAPPAPORT | ||||||||
| AuthorizedOfficialFirstName: | LEIGHANNE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2699488411 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.