MEDICARE: DLP MARQUETTE PHYSICIAN PRACTICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1205635760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DLP MARQUETTE PHYSICIAN PRACTICES INC

Provider Business Mailing Address
First Line	:	330 SEVEN SPRINGS WAY
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5098
Country	:	US
Telephone Number	:	615-920-7000
Fax Number	:	615-920-8775

Provider Business Practice Location Address
First Line	:	1414 W FAIR AVE STE 226
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-5409
Country	:	US
Telephone Number	:	906-449-1240
Fax Number	:	833-916-2234

Authorized Official
Title or Position	:	SECRETARY
Name	:	CHARLOTTE LAWRENCE
Credential	:
Telephone Number	:	615-920-7000

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	03/10/2025

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