Healthcare Provider Details

I. General information

NPI: 1598840498
Provider Name (Legal Business Name): MARLETTE REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 MAIN ST
MARLETTE MI
48453-1141
US

IV. Provider business mailing address

2770 MAIN ST PO BOX 307
MARLETTE MI
48453-1141
US

V. Phone/Fax

Practice location:
  • Phone: 989-635-4000
  • Fax: 989-635-4056
Mailing address:
  • Phone: 989-635-4000
  • Fax: 989-635-4056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL GUY BABCOCK
Title or Position: CEO
Credential:
Phone: 989-635-4002