| Full Name | |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 205 N. East Ave, Jackson, Michigan |
| Authorized Official Name and Position | Mark Smith (SVP, CMO, CEO) |
| Authorized Official Contact | 5172056407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 67000 Department 272801 Detroit MI 48267 Ph: (517) 841-7843 | 205 N. East Ave Jackson MI 49201 Ph: (517) 841-7843 |
| NPI Number | 1326585522 |
|---|---|
| Provider Enumeration Date | 01/25/2017 |
| Last Update Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326585522 | NPI | - | NPPES |
| 1760437826 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 1060000044 (Michigan) | Primary |
Aaron Van Wagnen Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1310 Greenwood Ave, Jackson, MI 49203 Phone: 517-787-1990 Fax: 517-787-9183 | |
Jackson Family Medical Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 724 W Franklin St, Jackson, MI 49201 Phone: 517-784-3100 Fax: 517-784-3200 | |
Lorna G. Pinson, Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 744 W Michigan Ave, Suite 101, Jackson, MI 49201 Phone: 517-782-2540 Fax: 517-782-1560 | |