James Jackson D.o., P.c. | |
2416 Peck Street James Jackson D.o., P.c. Muskegon Hts. MI 49444 | |
(231) 739-5574 | |
(231) 739-5574 |
Full Name | James Jackson D.o., P.c. |
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Speciality | Family Medicine |
Location | 2416 Peck Street, Muskegon Hts., Michigan |
Authorized Official Name and Position | James Jackson (OWNER) |
Authorized Official Contact | 23173955574 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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James Jackson D.o., P.c. 2416 Peck Street James Jackson D.o., P.c. Muskegon Hts. MI 49444 Ph: (231) 739-5574 | James Jackson D.o., P.c. 2416 Peck Street James Jackson D.o., P.c. Muskegon Hts. MI 49444 Ph: (231) 739-5574 |
NPI Number | 1619289642 |
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Provider Enumeration Date | 07/07/2010 |
Last Update Date | 10/08/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619289642 | NPI | - | NPPES |
1006466 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | JJ004758 (Michigan) | Primary |
208D00000X | General Practice | 5101004758 (Michigan) | Secondary |