| Mark A Jackson Md Plc | |
|
1000 Pavillions Cir Traverse City MI 49684-3198 | |
| (231) 935-0913 | |
| (231) 935-0984 |
| Full Name | Mark A Jackson Md Plc |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 1000 Pavillions Cir, Traverse City, Michigan |
| Authorized Official Name and Position | Mark A Jackson (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2319350913 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A Jackson Md Plc Po Box 1267 Traverse City MI 49685-1267 Ph: (231) 935-0913 | Mark A Jackson Md Plc 1000 Pavillions Cir Traverse City MI 49684-3198 Ph: (231) 935-0913 |
| NPI Number | 1740439025 |
|---|---|
| Provider Enumeration Date | 09/11/2008 |
| Last Update Date | 12/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740439025 | NPI | - | NPPES |
| 0B81350 | Other | MI | BCBS GROUP ID# |
| 1073585238 | Other | MI | IND NPI |
| 0802802421 | Other | MI | BCBS PIN# |
| 080B813500 | Other | MI | BCBS ID# |
| 1740439025 | Other | MI | GROUP NPI |
| 0MI1114 | Other | MI | MEDICARE GROUP |
| 1073585238 | Medicaid | MI | |
| MI1114001 | Other | MI | MEDICARE IND PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 4301051555 (Michigan) | Primary |
Munson Walk In Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3074 N Us 31 S, Traverse City, MI 49684 Phone: 231-929-1234 Fax: 231-935-0984 | |
County Health Support Services Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Washington St, Traverse City, MI 49684 Phone: 231-922-4532 | |
Best Medical Services Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 814 S Garfield Ave Ste C, Traverse City, MI 49686 Phone: 231-922-8722 Fax: 231-486-6042 | |
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Partners In Health Of Traverse City Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3074 N Us 31 S, Traverse City, MI 49684 Phone: 231-935-0535 Fax: 231-935-0454 | |
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