Healthcare Provider Details

I. General information

NPI: 1710693346
Provider Name (Legal Business Name): DICKINSON COUNTY HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 W FAIR AVE STE 334
MARQUETTE MI
49855-5407
US

IV. Provider business mailing address

1000 N OAK AVE ATTN: PROVIDER ENROLLMENT SERVICES SHP FL2
MARSHFIELD WI
54449-5703
US

V. Phone/Fax

Practice location:
  • Phone: 906-225-4500
  • Fax:
Mailing address:
  • Phone: 715-389-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN A BRESSLER
Title or Position: COO, AO
Credential:
Phone: 715-975-6018