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General NPI Number Information
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NPI Number | 1497944433
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC ASSOCIATES OF MARQUETTE
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 450 E RIDGE ST
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City | MARQUETTE
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State | MI
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Zip | 49855-4215
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Country | US
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Telephone | 906-226-6802
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Fax |
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Provider Business Mailing Address
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Address Line | 450 E RIDGE ST
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City | MARQUETTE
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State | MI
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Zip | 49855-4215
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Country | US
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Telephone | 906-226-6802
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. JOSEPH MICHAEL COOLS
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Credential | M.D.
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Telephone | 906-226-6802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 4301055159
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301053783
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License Number State | MI
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