Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | JH072024 | MI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 4301072024 | MI |
NPI | 1164422218 |
---|---|
Provider Name | Dr. Jon D Hop |
First Address | Holland, MI 49424-2196 |
Second Address | Holland, MI 49424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 30/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3474897 | (05) | MI |
5637634 | AETNA (01) | MI |
G71848 | (02) | MI |
JH072024 | STATE LICENSE (01) | MI |
P94459 | BLUE CARE NETWORK (01) | MI |