Leja Jackson Inc | |
920 S Huron St Cheboygan MI 49721-2267 | |
(231) 597-8192 | |
(231) 597-8463 |
Full Name | Leja Jackson Inc |
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Speciality | Family Medicine |
Location | 920 S Huron St, Cheboygan, Michigan |
Authorized Official Name and Position | Loretta M Leja (OWNER) |
Authorized Official Contact | 2315978192 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Leja Jackson Inc 920 S Huron St Cheboygan MI 49721-2267 Ph: (231) 597-8192 | Leja Jackson Inc 920 S Huron St Cheboygan MI 49721-2267 Ph: (231) 597-8192 |
NPI Number | 1235209099 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 05/06/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235209099 | NPI | - | NPPES |
4559907 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4301042693 (Michigan) | Primary |