Organization
FAMILY ORTHOPEDIC ASSOCIATES P L C
Active
Other names
OrthoMichigan/OrthoMichigan NOW/OrthoMichigan Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KELSEY (DIRECTOR OF OPERATIONS)
(810) 733-1200
Entity
Organization
Contact information
Practice address
4466 W BRISTOL RD, FLINT, MI 48507-3170
(810) 733-1200
(810) 733-0688
Mailing address
4466 W BRISTOL RD, FLINT, MI 48507-3170
(810) 733-1200
(810) 733-0688
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301038287
MI
207XS0117X
Orthopaedic Surgery of the Spine Physician
4301060979
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
4301059287
MI
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
5601001619
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51156
BCBSM PROVIDER ID #
MI
01
—
0N45090
GROUP MEDICARE PTAN
MI
05
—
1215930490
—
MI
Enumeration date
05/23/2005
Last updated
09/19/2024
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