Basic Information
| Provider Information | |||||||||
| NPI: | 1922116094 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PATHOLOGY ASSOCIATES INC PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 638039 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452638039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002888325 | ||||||||
| FaxNumber: | 4198665453 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 HURLEY PLZ | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485035902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102629134 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2006 | ||||||||
| LastUpdateDate: | 01/27/2022 | ||||||||
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| AuthorizedOfficialLastName: | BLIGHT | ||||||||
| AuthorizedOfficialFirstName: | CATHY | ||||||||
| AuthorizedOfficialMiddleName: | O | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8102629134 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 0999215 | 01 | MI | HEALTHPLUS OF MI | OTHER | 0B56001 | 01 | MI | BLUE CROSS BLUE SHIELD | OTHER | 220B56001 | 01 | MI | SELECTCARE | OTHER | 000000009429 | 01 | MI | CAPE HEALTH PLAN | OTHER | 023834 | 01 | MI | HEALTH ALLIANCE PLAN | OTHER | 025953 | 01 | MI | MIDWEST HEALTH PLAN | OTHER | CE4259 | 01 | MI | RAILROAD MEDICARE | OTHER | LP250004 | 01 | MI | M-CARE | OTHER | 29692 | 01 | MI | COMMUNITY CHOICE OF MI | OTHER |