# PHYSICIAN'S HOME NETWORK, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386971711
- **Authorized official:** KURTIS SMITKO MSPT (CEO)
- **Authorized official phone:** (616) 608-7403

## Contact information

- **Practice address:** 3033 ORCHARD VISTA DR SE, SUITE 309, GRAND RAPIDS, MI 49546-7077
- **Practice address phone:** (616) 608-7403
- **Practice address fax:** (616) 608-7408
- **Mailing address:** 3033 ORCHARD VISTA DR SE, SUITE 309, GRAND RAPIDS, MI 49546-7077
- **Mailing address phone:** (616) 608-7403
- **Mailing address fax:** (616) 608-7408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/05/2009
- **Last updated:** 11/05/2009