| Dr Avery Michael Jackson Iii, MD | |
|
9400 S Saginaw Rd Ste A, Grand Blanc, MI 48439-9666 | |
| (810) 606-7200 | |
| (810) 606-7115 |
| Full Name | Dr Avery Michael Jackson Iii |
|---|---|
| Gender | Male |
| Speciality | Neurological Surgery |
| Location | 9400 S Saginaw Rd Ste A, Grand Blanc, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851329197 | NPI | - | NPPES |
| 0993708 | Other | MI | HEALTHPLUS OF MICHIGAN |
| 4568263 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207T00000X | Neurological Surgery | AJ076974 (Michigan) | Primary |
| Entity Name | Michigan Neurosurgical Institute, P.c |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336184571 PECOS PAC ID: 9931094802 Enrollment ID: O20040408001119 |
| Entity Name | Advanced Wound Care Of Caro Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700666708 PECOS PAC ID: 3678926227 Enrollment ID: O20240130003071 |
| Entity Name | Advanced Pain Management Of Caro Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780454587 PECOS PAC ID: 2264878289 Enrollment ID: O20240313002076 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Avery Michael Jackson Iii, MD 4620 Genesys Pkwy, Grand Blanc, MI 48439-8067 Ph: (810) 606-7200 | Dr Avery Michael Jackson Iii, MD 9400 S Saginaw Rd Ste A, Grand Blanc, MI 48439-9666 Ph: (810) 606-7200 |
Dr. Lisa L Guyot, MD PHD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 841 Health Park Boulevard, Grand Blanc, MI 48439 Phone: 810-606-7340 Fax: 810-606-7770 |