| Jackson Health Services | |
|
4727 Saint Antoine St Ste 202 Detroit MI 48201-1461 | |
| (313) 831-8805 | |
| (313) 832-8206 |
| Full Name | Jackson Health Services |
|---|---|
| Speciality | Family Medicine |
| Location | 4727 Saint Antoine St, Detroit, Michigan |
| Authorized Official Name and Position | Mary Jackson-hammond (PRESIDENT) |
| Authorized Official Contact | 3138318805 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Health Services 4727 Saint Antoine St Ste 202 Detroit MI 48201-1461 Ph: (313) 831-8805 | Jackson Health Services 4727 Saint Antoine St Ste 202 Detroit MI 48201-1461 Ph: (313) 831-8805 |
| NPI Number | 1093134348 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 04/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093134348 | NPI | - | NPPES |
| 4180604 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301046737 (Michigan) | Primary |
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