DR. STEPHEN P KOLT, D.C. - NPI NUMBER 1194805069

Summary

Provider Name: DR. STEPHEN P KOLT, D.C.

NPI Number: 1194805069

Clasification: Chiropractor (111N00000X)

Address:
1508 US 31 N
PETOSKEY, MI
ZIP 49770

Phone Number: (231) 347-0420



Detailed Information

DR. Stephen P Kolt, D.C. is a chiropractor in Petoskey, MI with 35 years of experience. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. The assigned NPI number for this provider is 1194805069 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SHERMAN COLLEGE OF STRAIGHT CHIROPRACTIC
Graduation Year: 1979

The provider's business address is:

1508 US 31 N
PETOSKEY, MI
ZIP 49770-065
Phone: (231) 347-0420

The enumeration date for this NPI number is 10/16/2006 and was last updated on 7/9/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 111N00000X Chiropractor 2301004040 MI Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 0B45006 MEDICARE ID-TYPE UNSPECIFIED MI MEDICARE

NPI Record

No. Field Name Field Value
1 NPI 1194805069
2 Entity Type Code 1
3 Provider Last Name Legal Name KOLT
4 Provider First Name STEPHEN
5 Provider Middle Name P
6 Provider Name Prefix Text DR.
7 Provider Credential Text D.C.
8 Provider First Line Business Practice Location Address 1508 US 31 N
9 Provider Business Practice Location Address City Name PETOSKEY
10 Provider Business Practice Location Address State Name MI
11 Provider Business Practice Location Address Postal Code 497700065
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 2313470420
14 Provider Enumeration Date 10/16/2006
15 Last Update Date 7/9/2007
16 Provider Gender Code M
17 Healthcare Provider Taxonomy Code 1 111N00000X
18 Provider License Number 1 2301004040
19 Provider License Number State Code 1 MI
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 0B45006
22 Other Provider Identifier Type Code 1 04
23 Other Provider Identifier State 1 MI
24 Other Provider Identifier Issuer 1 MEDICARE
25 Is Sole Proprietor Y

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.