Provider Demographics
NPI:1871619965
Name:VANHUYSEN, JAMES THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:VANHUYSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:BOX 42
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-349-3350
Mailing Address - Fax:269-349-2403
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M-424
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-349-3350
Practice Address - Fax:269-349-2403
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101015731207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200C911390OtherBCBS
MI0C97618OtherBCBS
MI0C97618269Medicaid
MI1871619965Medicaid
MI200C911390OtherBCBS
MI0C97618269Medicaid