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General NPI Number Information
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NPI Number | 1659868206
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Entity Type | Organization
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Legal Business Name | MACKINAC STRAITS HEALTH SYSTEM INC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 920 S HURON ST
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City | CHEBOYGAN
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State | MI
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Zip | 49721-2267
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Country | US
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Telephone | 231-597-8192
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Fax | 231-597-8463
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Provider Business Mailing Address
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Address Line | 1140 N STATE ST
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City | SAINT IGNACE
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State | MI
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Zip | 49781-1048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | SONJA SPRAGUE
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Credential |
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Telephone | 906-643-0451
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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