Hershel Jackson MD

NPI 1023153178 - Internal Medicine - 207RE0101X

NPI Details
NPI 1023153178
Gender Male
Enumeration Date 02/20/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3990 JOHN R ST
DETROIT MI, 48201-2018, US
Phone (313) 745-8040
Fax
Business Location
23077 GREENFIELD RD STE 450
SOUTHFIELD MI, 48075-3760, US
Phone (248) 559-8810
Fax
Toxanomy
Taxonomy Code 207RE0101X
License State Michigan
License Number 4301043930
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According to our database, Hershel Jackson MD NPI is 1023153178, taxonomy code is 207RE0101X and license number is 4301043930, license state is located at Michigan. Hershel Jackson MD physically located at 3990 John R St, Detroit MI, 48201-2018. NPI Number Hershel Jackson MD has the Individual type.

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1023153178 NPI number is provided on an as is basis without warranty of any kind. 1023153178 is maintained by the National Plan & Provider Enumeration System. The contents of Hershel Jackson MD are for informational purposes only.