Provider Demographics
NPI:1609165448
Name:KERNS, GARRETT JAMES (DO)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:JAMES
Last Name:KERNS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 W FAIR AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-5406
Mailing Address - Country:US
Mailing Address - Phone:906-225-1321
Mailing Address - Fax:906-228-9371
Practice Address - Street 1:1414 W FAIR AVE STE 190
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-5406
Practice Address - Country:US
Practice Address - Phone:906-225-1321
Practice Address - Fax:906-228-9371
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13575207X00000X
CO62342207XX0005X
MI5101022147207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery