Organization
HART FAMILY MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUDY C OCHS DO (PRESIDENT)
(231) 873-5675
Entity
Organization
Contact information
Practice address
611 EAST MAIN ST, HART, MI 49420-1190
(231) 873-5675
(231) 873-4805
Mailing address
611 EAST MAIN ST, HART, MI 49420-1190
(231) 873-5675
(231) 873-4805
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
AB03370
MI
207Q00000X
Family Medicine Physician
4101133105
MI
207Q00000X
Family Medicine Physician
5101009698
MI
207Q00000X
Family Medicine Physician
5101011414
MI
207Q00000X
Family Medicine Physician
5101011554
MI
207Q00000X
Family Medicine Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01027
PRIORITY HEALTH GRP #
MI
01
—
010F476090
BCBS GROUP NUMBER
MI
01
—
11272959
CAQH ID NUMBER
MI
01
—
3015197 TYPE 11
PAUL A WAGNER
MI
05
—
4338002 TYPE 11
—
MI
01
—
500F4710070
BCBS NP GROUP NUMBER
MI
01
—
8008974220
BCBS MI
MI
01
—
800F410320
BCBSMI
MI
Enumeration date
06/20/2005
Last updated
05/22/2009
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