Healthcare Provider Details

I. General information

NPI: 1013695626
Provider Name (Legal Business Name): COMPASS POINTE MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W COLBY ST STE D
WHITEHALL MI
49461-1084
US

IV. Provider business mailing address

116 W COLBY ST STE D
WHITEHALL MI
49461-1084
US

V. Phone/Fax

Practice location:
  • Phone: 231-292-1240
  • Fax: 231-292-1088
Mailing address:
  • Phone: 231-740-6370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER KOETJE
Title or Position: OWNER
Credential: PA
Phone: 231-740-6370