Provider Demographics
NPI:1619155611
Name:BARRETT AND DRISCOLL,MD'S,PC
Entity Type:Organization
Organization Name:BARRETT AND DRISCOLL,MD'S,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-983-6518
Mailing Address - Street 1:2516 NILES AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1937
Mailing Address - Country:US
Mailing Address - Phone:269-983-6518
Mailing Address - Fax:269-983-0955
Practice Address - Street 1:2516 NILES AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1937
Practice Address - Country:US
Practice Address - Phone:269-983-6518
Practice Address - Fax:269-983-0955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301050634174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty