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General NPI Number Information
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NPI Number | 1609165448
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Entity Type | Individual
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Provider Name | GARRETT JAMES KERNS D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 1414 W FAIR AVE STE 190
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City | MARQUETTE
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State | MI
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Zip | 49855-5406
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Country | US
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Telephone | 906-225-1321
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Fax | 906-228-9371
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Provider Business Mailing Address
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Address Line | 1414 W FAIR AVE STE 190
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City | MARQUETTE
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State | MI
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Zip | 49855-5406
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Country | US
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Telephone | 906-225-1321
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Fax | 906-228-9371
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 20A13575
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 62342
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 5101022147
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License Number State | MI
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