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300 W Washington Ave Suite 060 Jackson MI 49201-2180 | |
| (517) 787-5970 | |
| (517) 787-3353 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 300 W Washington Ave, Jackson, Michigan |
| Authorized Official Name and Position | Michelle Mayo (PATIENT ACCOUNT SUPERVISOR) |
| Authorized Official Contact | 5177843950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 548 Jackson MI 49204-0548 Ph: (517) 784-3950 | 300 W Washington Ave Suite 060 Jackson MI 49201-2180 Ph: (517) 787-5970 |
| NPI Number | 1144390675 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 09/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144390675 | NPI | - | NPPES |
| 500C807070 | Other | MI | BCBSM GROUP PROVIDER |
| 700C810070 | Other | MI | BLUE CROSS BLUE SHIELD |
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