Provider Demographics
NPI:1285606723
Name:THOMAS C HOSEY DPM & ASSOCIATES PC
Entity type:Organization
Organization Name:THOMAS C HOSEY DPM & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:586-263-4411
Mailing Address - Street 1:42550 GARFIELD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1644
Mailing Address - Country:US
Mailing Address - Phone:586-263-4411
Mailing Address - Fax:586-263-1151
Practice Address - Street 1:253 S GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2410
Practice Address - Country:US
Practice Address - Phone:586-468-5445
Practice Address - Fax:586-468-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001045213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDB8851OtherRAIL ROAD MEDICARE
MI0N89580Medicare ID - Type UnspecifiedMEDICARE GROUP
MI5110230001Medicare NSC