1730112673 NPI number — MARKLE CHIROPRACTIC PC

Table of content: (NPI 1730112673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730112673 NPI number — MARKLE CHIROPRACTIC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARKLE CHIROPRACTIC PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SALZBURG CHIROPRACTIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730112673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 SALZBURG RD
Provider Second Line Business Mailing Address:
SALZBURG CHIROPRACTIC
Provider Business Mailing Address City Name:
BAY CITY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-684-3200
Provider Business Mailing Address Fax Number:
989-684-9436

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 SALZBURG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAY CITY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-684-3200
Provider Business Practice Location Address Fax Number:
989-684-9436
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MARKLE
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
PATRICK
Authorized Official Title or Position:
PRESIDENT OWNER
Authorized Official Telephone Number:
989-684-3200

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  RM006985 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0Z95003 . This is a "MR" identifier . This identifiers is of the category "OTHER".
  • Identifier: DA9424 . This is a "RAILROAD MEDICARE GROUP N" identifier . This identifiers is of the category "OTHER".
  • Identifier: RM006985 . This is a "BC NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1010003 . This is a "MCLAREN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0991152 . This is a "HEALTH PLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: ON88200001 . This is a "MR" identifier . This identifiers is of the category "OTHER".
  • Identifier: RM006985 . This is a "BC" identifier . This identifiers is of the category "OTHER".
  • Identifier: ON88200 . This is a "MR GROUP NO" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00079165 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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