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DOUGLAS TACKET DO PLLC
NPI 1023145703
Family Medicine in Niles, MI

Active since February 28, 2007
24 N SAINT JOSEPH AVE, SUITE G, NILES, MI 49120(269) 684-5002 Get Directions Write a Review

NPPES record last updated: March 15, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Douglas Tacket Do Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS TACKET DO PLLC (NPI 1023145703) is a healthcare organization registered as a family medicine in Niles, Michigan and active in the NPI registry since February 2007. The organization lists Douglas Tacket, Owner, as its authorized official.

NPPES Registry Identity

NPI1023145703
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDOUGLAS TACKET DO PLLC
Location Address24 N SAINT JOSEPH AVE, SUITE GNiles, MI 49120-2263
Mailing Address3061 Christy WaySaginaw, MI 48603-2267 · (989) 791-2455 · Fax (989) 791-1392
Phone(269) 684-5002
Organization SubpartNo
Authorized OfficialDouglas TacketOwner · (269) 684-5002
Enumeration DateFebruary 28, 2007
Last NPPES UpdateMarch 15, 2010
✔ NPI 1023145703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 5101012140
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
24 N SAINT JOSEPH AVE, Niles, MI 49120
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Other Identifiers 3

Medicare UPINE95811MI
Medicaid4560327MI
Medicare PIN0N79920MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL L FLEWELLING DDS
Dentist (General Practice)
24 N SAINT JOSEPH AVE, SUITE E-2
NILES, MI 49120
Berrien County (269) 683-4180
GREATER NILES CARDIOLOGY PC
Internal Medicine (Cardiovascular Disease)
24 N SAINT JOSEPH AVE, SUITE F1
NILES, MI 49120
Berrien County (269) 687-9575
MR. JOE FRANCISCO MSW, LCSW
Social Worker (Clinical)
24 N SAINT JOSEPH AVE, SUITE G
NILES, MI 49120
Berrien County (269) 684-6870
CARDIOVASCULAR DISEASES OF NILES, P.C.
Internal Medicine (Cardiovascular Disease)
24 N SAINT JOSEPH AVE, SUITE A
NILES, MI 49120
Berrien County (269) 683-1120
MIKE FLEWELLING DDS PLC
Dentist (General Practice)
24 N SAINT JOSEPH AVE, SUITE E-2
NILES, MI 49120
Berrien County (269) 683-4180
STEPHANIE MARIE MANN
Social Worker (Clinical)
24 N SAINT JOSEPH AVE
NILES, MI 49120
Berrien County (269) 684-4270
WEST MICHIGAN HEARING SPECIALISTS LLC
Audiologist-Hearing Aid Fitter
24 N SAINT JOSEPH AVE, SUITE C-1
NILES, MI 49120
Berrien County (269) 683-0800
PAUL V DETRISAC MD PC
Internal Medicine
24 N SAINT JOSEPH AVE
NILES, MI 49120
Berrien County (269) 684-8356

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Tacket Do PLLC's NPI number?

The NPI number for Douglas Tacket Do PLLC is 1023145703. It was assigned to this organization in the NPPES registry on February 28, 2007.

Where is Douglas Tacket Do PLLC located?

Douglas Tacket Do PLLC is located at 24 N Saint Joseph Ave Suite G, Niles, MI 49120. The listed phone number is (269) 684-5002.

What is Douglas Tacket Do PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Douglas Tacket Do PLLC was last updated on March 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.