Provider Demographics
NPI:1376840686
Name:JOSEPH NATOLE,JR,MD,PC
Entity Type:Organization
Organization Name:JOSEPH NATOLE,JR,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:NATOLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:989-793-4747
Mailing Address - Street 1:4701 TOWNE CTR STE 103
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2800
Mailing Address - Country:US
Mailing Address - Phone:989-793-4747
Mailing Address - Fax:989-793-5450
Practice Address - Street 1:4701 TOWNE CTR STE 103
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2800
Practice Address - Country:US
Practice Address - Phone:989-793-4747
Practice Address - Fax:989-793-5450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJN50537208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2581408Medicaid
D73098Medicare UPIN