| Henry Ford Allegiance Health | |
|
205 N East Ave Jackson MI 49201-1753 | |
| (517) 788-4800 | |
| Not Available |
| Full Name | Henry Ford Allegiance Health |
|---|---|
| Speciality | Family Medicine |
| Location | 205 N East Ave, Jackson, Michigan |
| Authorized Official Name and Position | Mark Smith (SVP - CMO, CEO - HFA) |
| Authorized Official Contact | 5172056407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Henry Ford Allegiance Health Department 272801 Po Box 67000 Detroit MI 48267-2728 Ph: (517) 841-7482 | Henry Ford Allegiance Health 205 N East Ave Jackson MI 49201-1753 Ph: (517) 788-4800 |
| NPI Number | 1215974332 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215974332 | NPI | - | NPPES |
| 700C312920 | Other | MI | BCBSM # |
| CC5829 | Other | MI | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Michigan) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (Michigan) | Secondary |
| 363A00000X | Physician Assistant | (Michigan) | Secondary |
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