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JACKSON HEALTH SERVICES NPI 1093134348


NPI Information

NPI: 1093134348
Provider Name: JACKSON HEALTH SERVICES
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
4727 SAINT ANTOINE ST
STE 202
DETROIT, MI
ZIP 48201
Phone: (313) 831-8805
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JACKSON HEALTH SERVICES is a family medicine in Detroit, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JACKSON HEALTH SERVICES NPI is 1093134348. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4727 SAINT ANTOINE ST
STE 202
DETROIT, MI
ZIP 48201-461
Phone: (313) 831-8805
Fax: (313) 832-8206

The provider's authorized official is Mary Jackson-hammond .
The authorized official title is President and has the following contact phone number (313) 831-8805.

The enumeration date for this NPI number is 4/15/2014 and was last updated on 4/15/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine4301046737MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14180604MEDICAIDMICHIGAN
2M12315MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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