JACKSON ORTHOPEDIC SPECIALIST NPI 1568671857

NPI Information

  • NPI: 1568671857
  • Provider Name: JACKSON ORTHOPEDIC SPECIALIST
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 1100 E MICHIGAN AVE
    SUITE 308
    JACKSON, MI
    ZIP 49201
  • Phone: (517) 787-3900

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NPI Details

JACKSON ORTHOPEDIC SPECIALIST is a specialist in Jackson, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. JACKSON ORTHOPEDIC SPECIALIST NPI is 1568671857. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1100 E MICHIGAN AVE
SUITE 308
JACKSON, MI
ZIP 49201-847
Phone: (517) 787-3900
Fax: (517) 787-4318

The provider's authorized official is Cheri Brautigam .
The authorized official title is Office Manager and has the following contact phone number (517) 780-9257.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 8/22/2020.

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
1174400000XSpecialistRB072498MICHIGANYes

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
14637511MEDICAIDMICHIGAN

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: 11/21/2025

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