| Michele Johnson, DO | |
|
205 N East Ave, Jackson, MI 49201-1753 | |
| (517) 788-4800 | |
| (517) 817-7050 |
| Full Name | Michele Johnson |
|---|---|
| Gender | Female |
| Speciality | Emergency Medicine |
| Location | 205 N East Ave, Jackson, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588015879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 5101024917 (Michigan) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Michigan) | Secondary |
| Entity Name | Independent Emergency Physicians Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780791343 PECOS PAC ID: 6709798325 Enrollment ID: O20031103000407 |
| Entity Name | Independent Observation Physicians Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700119500 PECOS PAC ID: 3577603604 Enrollment ID: O20091221000327 |
| Entity Name | Iep Observation Medicine - Jackson Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982478251 PECOS PAC ID: 6800234592 Enrollment ID: O20240401000555 |
| Mailing Address | Practice Location Address |
|---|---|
| Michele Johnson, DO 205 N East Ave, Jackson, MI 49201-1753 Ph: (517) 788-4800 | Michele Johnson, DO 205 N East Ave, Jackson, MI 49201-1753 Ph: (517) 788-4800 |
Jonathan F. Bradley, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 Fax: 517-796-6410 | |
Ross Warren Kynast, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 Fax: 248-893-6952 | |
Kevin Killian, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 | |
Deepa S Macha, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4996 Fax: 517-796-6410 | |
Dr. Gregory W Fuller, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1006 Airport Rd, Jackson, MI 49202 Phone: 517-784-6663 Fax: 517-787-7976 | |
Jared Tippett, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 | |
Dr. Brett Mcknight Russell, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 |