Paul Jackson D.O.

NPI 1053391342 - Family Medicine - 207Q00000X

NPI Details
NPI 1053391342
Gender Male
Enumeration Date 01/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
17800 NEWBURGH RD
SUITE 103
LIVONIA MI, 48152-2700, US
Phone (734) 464-9540
Fax (734) 464-0438
Business Location
17800 NEWBURGH RD
SUITE 103
LIVONIA MI, 48152-2700, US
Phone (734) 464-9540
Fax (734) 464-0438
Toxanomy
Taxonomy Code 207Q00000X
License State Michigan
License Number 5101012453
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According to our database, Paul Jackson D.O. NPI is 1053391342, taxonomy code is 207Q00000X and license number is 5101012453, license state is located at Michigan. Paul Jackson D.O. physically located at 17800 Newburgh Rd, Livonia MI, 48152-2700. NPI Number Paul Jackson D.O. has the Individual type.

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1053391342 NPI number is provided on an as is basis without warranty of any kind. 1053391342 is maintained by the National Plan & Provider Enumeration System. The contents of Paul Jackson D.O. are for informational purposes only.