DR. MARCUS KYLE FREE M.D. NPI 1790949097

NPI Information

NPI: 1790949097
Provider Name: DR. MARCUS KYLE FREE, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2143 DERFLA DR
SAINT JOSEPH, MI
ZIP 49085
Phone: (888) 550-5154
Get Directions

DR. Marcus Kyle Free, M.D. is a general practice in Saint Joseph, MI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Marcus Kyle Free, M.D. NPI is 1790949097. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2143 DERFLA DR
SAINT JOSEPH, MI
ZIP 49085-661
Phone: (888) 550-5154
Fax: (888) 414-4545

The NPI 1790949097 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/16/2008 and was last updated on 10/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	208600000X	Surgery	4301093347	MICHIGAN	No
2	208600000X	Surgery	L0799	TEXAS	No
3	208D00000X	General Practice	4301093347	MICHIGAN	No
4	208D00000X	General Practice	LO799	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	105431333	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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