Organization
HASTINGS ORTHOPEDIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY SHELLENBARGER (BILLING SUPERVISOR)
(269) 945-4966
Entity
Organization
Contact information
Practice address
840 COOK RD, HASTINGS, MI 49058-9616
(269) 945-9520
(269) 945-3368
Mailing address
840 COOK RD, PO BOX 290, HASTINGS, MI 49058-9616
(269) 945-9520
(269) 945-3368
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301035154
MI
207X00000X
Orthopaedic Surgery Physician
5101012880
MI
208100000X
Physical Medicine & Rehabilitation Physician
5101013049
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101378087
—
MI
05
—
114206086
—
MI
05
—
114316909
—
MI
01
—
200Z800130
KSM BCBS
MI
01
—
5101012880
JLH BSBS
MI
01
—
5101013049
ESL BCBS
MI
01
—
5201000567
SUE BCBS
MI
01
—
5501012232
JENNY BCBS
MI
Enumeration date
03/13/2007
Last updated
04/23/2008
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