JCR DO PLC NPI 1215048384

NPI Information

NPI: 1215048384
Provider Name: JCR DO PLC

Doing Business As: DELTON MEDICAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
11275 SPRAGUE RD
DELTON, MI
ZIP 49046
Phone: (269) 623-7121
Get Directions

JCR DO PLC is a family medicine in Delton, 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. JCR DO PLC NPI is 1215048384. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Delton Medical Center.

The provider's business location address is:

11275 SPRAGUE RD
DELTON, MI
ZIP 49046-493
Phone: (269) 623-7121
Fax: (269) 623-5527

The provider's authorized official is Joseph C. Roth .
The authorized official title is Owner and has the following contact phone number (269) 623-7121.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 12/15/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		5101008208	MICHIGAN	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0N98930001	MEDICARE PIN	MICHIGAN
2	4639104	MEDICAID	MICHIGAN
3	=========	OTHER	MICHIGAN	TAX ID NUMBER
4	0M9860017	MEDICARE PIN
5	383530765	OTHER	MICHIGAN	TAX ID
6	E26163	MEDICARE UPIN	MICHIGAN

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: 5/5/2024

NPI Synchronization or Removal

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