Provider Demographics
NPI:1154581171
Name:GRAND BLANC MEDICAL IMAGING, PLC
Entity type:Organization
Organization Name:GRAND BLANC MEDICAL IMAGING, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-733-2769
Mailing Address - Street 1:2222 SOUTH LINDEN ROAD
Mailing Address - Street 2:SUITE R
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5475
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9475 HOLLY ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439
Practice Address - Country:US
Practice Address - Phone:810-733-2769
Practice Address - Fax:810-733-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty