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Organization

CENTRAL MICHIGAN FAMILY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BROCK W HORSLEY D.O (OWNER)
(989) 588-6153
Entity
Organization

Contact information

Practice address
522 EAST MAIN STREET, FARWELL, MI 48622
(989) 588-6153
(989) 588-6194
Mailing address
522 EAST MAIN STREET, FARWELL, MI 48622
(989) 588-6153
(989) 588-6194

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101014871
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101842
PHP UNITED HEALTHCARE
MI
01
0853701105
BLUE CROSS BLUE SHIELD
MI
01
1012731
MCLAREN HEALTH PLAN
MI
05
114637450
MI
01
610677100
US DEPT OF LABOR
Enumeration date
07/20/2006
Last updated
12/10/2010
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