DLP Marquette Physician Practices Inc
Organization Active NPI Physical Medicine & Rehabilitation Physician · Marquette, MI
NPI 1013265065 · NPPES record last updated Mar 9, 2025
Key facts
- NPI
- 1013265065
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- Legal business name
- DLP MARQUETTE PHYSICIAN PRACTICES INC
- Practice address
- 580 W College Ave
Marquette, MI 49855-2736 - Phone
- (906) 225-3993
- Fax
- (906) 225-4589
- NPI assigned
- Aug 23, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- DLP MARQUETTE PHYSICIAN PRACTICES INC
Authorized official
- Name
- Charlotte Lawrence
- Title
- Secretary
- Phone
- (615) 920-7000
Other NPIs on the same Medicare enrollment 33
Practitioners 2
-
Brian Jon Macfalda, DO, MBA
-
John R Wallace, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121016000312 | MI | Part B Supplier - Clinic/Group Practice | 9931359601 |
Receives reassigned benefits from 467 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Marquette, MI; Negaunee, MI; Newberry, MI; Escanaba, MI; Ontonagon, MI; Sault Sainte Marie, MI; Ternary, MI; Manistique, MI… |
National Provider Directory
- Part of
- DLP Marqutte Physician Practices Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician |
208100000X | Yes |
Addresses
Primary practice location
580 W College Ave
Marquette, MI 49855-2736
Mailing address
580 W College Ave
Marquette, MI 49855-2736
Phone (906) 225-3993
Other names
- MARQUETTE GENERAL WALKING & GAIT CLINIC
Other providers in Marquette, MI
- DLP Marquette General Hospital LLC
- DLP Marquette General Hospital LLC
- DLP Marquette General Hospital LLC
- DLP Marquette General Hospital LLC
- DLP Marquette General Hospital LLC
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
- DLP Marquette Physician Practices Inc
All providers in Marquette, MI · Physical Medicine & Rehabilitation Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.