Provider Demographics
NPI:1528173184
Name:JOHN P QUARTON PC
Entity type:Organization
Organization Name:JOHN P QUARTON PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:QUARTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-802-6756
Mailing Address - Street 1:7508 PONTIAC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1425
Mailing Address - Country:US
Mailing Address - Phone:248-802-6756
Mailing Address - Fax:248-623-1917
Practice Address - Street 1:7508 PONTIAC LAKE RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1425
Practice Address - Country:US
Practice Address - Phone:248-802-6756
Practice Address - Fax:248-623-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJQ005246103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1881617512NOtherIND NPI NUMBER
MI0F32995OtherBCBS