Provider Demographics
NPI:1730151036
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:BILLING MGT
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
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 1:42550 GARFIELD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1644
Practice Address - Country:US
Practice Address - Phone:586-263-4411
Practice Address - Fax:586-263-1151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THOMAS C HOSEY DPM & ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-02
Last Update Date:2009-02-13
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
MI480E015590OtherBLUE CROSS BLUE SHIELD
MI5110230001OtherDME REGIONAL CARRIER
MIDB8851OtherRAIL ROAD MEDICARE
MI5110230001OtherDME REGIONAL CARRIER
MI=========OtherTAX ID
MI5110230001Medicare NSC