Provider Demographics
NPI:1316972581
Name:SOCEY, JOHN R (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:SOCEY
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Gender:M
Credentials:DO
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Mailing Address - Street 1:G3169 BEECHER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3611
Mailing Address - Country:US
Mailing Address - Phone:810-767-1420
Mailing Address - Fax:810-767-4685
Practice Address - Street 1:G3169 BEECHER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3611
Practice Address - Country:US
Practice Address - Phone:810-767-1420
Practice Address - Fax:810-767-4685
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MI5101005881208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8253048OtherBLUE CROSS
MIE26181OtherHAP
MI4073496OtherAETNA
MIC1630OtherMCARE
MIE26181OtherHAP