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General NPI Number Information
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NPI Number | 1639288269
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Entity Type | Individual
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Provider Name | GEORGE EDWIN COMPTON JR. PH D
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10 VANS AVENUE
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City | COLDWATER
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State | MI
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Zip | 49036
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Country | US
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Telephone | 517-278-4741
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Fax | 269-651-3180
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Provider Business Mailing Address
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Address Line | 67782 KLINGER LAKE ROAD
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City | STURGIS
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State | MI
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Zip | 49091
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Country | US
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Telephone | 269-651-6949
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Fax | 269-651-3180
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301011736
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License Number State | MI
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