Organization Name: | KALKASKA MEMORIAL HEALTH CENTER |
NPI Number: | 1881967495 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES D AUSTIN (CEO/ADMINISTRATOR) |
Mailing Address: | 419 S Coral St Kalkaska |
State: | MI US |
Postal Code: | 496462503 |
Phone Number: | 2312587500 |
Fax Number: | 2312587527 |
NPI Enumeration Date: | 02/13/2012 |
NPI Last Update Date: | 02/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |