| Dr Rodger Dale Jackson Jr, DO, MPH | |
|
6777 W Maple Rd, Department Of Emergency Medicine, West Bloomfield, MI 48322-3013 | |
| (313) 614-2186 | |
| Not Available |
| Full Name | Dr Rodger Dale Jackson Jr |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 6777 W Maple Rd, West Bloomfield, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588795546 | NPI | - | NPPES |
| 5101016798 | Other | MI | LICENSE |
| 5315026355 | Other | MI | CONTROLLED SUBSTANCE LIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 5101016798 (Michigan) | Primary |
| 207R00000X | Internal Medicine | 5101016798 (Michigan) | Secondary |
| Entity Name | Henry Ford Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139 |
| Entity Name | Hospitalist Physicians Medical Group Of Michigan, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003978867 PECOS PAC ID: 4688778228 Enrollment ID: O20070409000434 |
| Entity Name | Epmg Downriver Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093085441 PECOS PAC ID: 6608038443 Enrollment ID: O20120424000499 |
| Entity Name | Vituity - Michigan Em Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144892332 PECOS PAC ID: 8022414010 Enrollment ID: O20210830002859 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Rodger Dale Jackson Jr, DO, MPH 6777 W Maple Rd, Department Of Emergency Medicine, West Bloomfield, MI 48322-3013 Ph: (313) 614-2186 | Dr Rodger Dale Jackson Jr, DO, MPH 6777 W Maple Rd, Department Of Emergency Medicine, West Bloomfield, MI 48322-3013 Ph: (313) 614-2186 |
Jennifer Lee Franklin, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6777 W Maple Rd, West Bloomfield, MI 48322 Phone: 843-876-8023 | |
Jonathan David Samuels, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 5111 Cedarhurst Dr, West Bloomfield, MI 48322 Phone: 248-470-2348 Fax: 248-668-9222 | |
Howard Stephen Lasser, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 5968 Shillingham Dr, West Bloomfield, MI 48322 Phone: 248-788-0075 | |
Shivani Patel Lasater, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6777 W Maple Rd, West Bloomfield, MI 48322 Phone: 248-661-6450 Fax: 248-661-6447 | |
Dr. Steven Rockoff, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 6777 W Maple Rd, West Bloomfield, MI 48322 Phone: 248-325-1555 | |
Brooke Sherman, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6777 W Maple Rd, West Bloomfield, MI 48322 Phone: 248-325-1000 Fax: 248-325-1000 | |
Jawad A. Arshad, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: Henry Ford Health System, 6777 West Maple Road, West Bloomfield, MI 48323 Phone: 248-661-6455 |