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General NPI Number Information
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NPI Number | 1356316186
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Entity Type | Organization
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Legal Business Name | DOCTORS SERVICES INC
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 802 S MAIN ST STE 3
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City | CHEBOYGAN
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State | MI
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Zip | 49721-2269
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Country | US
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Telephone | 231-627-3002
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Fax | 231-627-6204
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Provider Business Mailing Address
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Address Line | 802 S MAIN ST STE 3
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City | CHEBOYGAN
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State | MI
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Zip | 49721-2269
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Country | US
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Telephone | 231-627-3002
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Fax | 231-627-6204
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Authorized Official
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Title or Position | PRESIDENT
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Name | RODERICK JAY BALTZER
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Credential | DO
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Telephone | 231-627-3002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101006586
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License Number State | MI
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