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NPI Code Detail

MEDICARE: DLP MARQUETTE PHYSICIAN PRACTICES INC

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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1790033207
Entity Type Code : Organization
Provider Name (Legal Business Name) : DLP MARQUETTE PHYSICIAN PRACTICES INC
Provider Business Mailing Address
First Line : 1500 W ICE LAKE RD
Second Line :
City : IRON RIVER
State : MI
Zip : 49935-8509
Country : US
Telephone Number : 906-265-5378
Fax Number : 906-265-6332
Provider Business Practice Location Address
First Line : 1500 W ICE LAKE RD
Second Line :
City : IRON RIVER
State : MI
Zip : 49935-8509
Country : US
Telephone Number : 906-265-5378
Fax Number : 906-265-6332
Authorized Official
Title or Position : PRESIDENT
Name : JESS N JUDY
Credential :
Telephone Number : 615-372-8500
Provider Enumeration Date : 08/15/2012
Last Update Date : 08/15/2012

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Directions to “DLP MARQUETTE PHYSICIAN PRACTICES INC ” Practice Location

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