# HERSHEL C JACKSON MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659536076
- **Authorized official:** DR. HERSHEL CLARK JACKSON MD (MEDICAL DOCTOR)
- **Authorized official phone:** (248) 559-8810

## Contact information

- **Practice address:** 23077 GREENFIELD RD, \#450, SOUTHFIELD, MI 48075
- **Practice address phone:** (248) 599-8810
- **Mailing address:** 23077 GREENFIELD RD, \#450, SOUTHFIELD, MI 48075
- **Mailing address phone:** (248) 599-8810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | AJ043930 | MI | Yes |

## Other

- **Enumeration date:** 07/24/2008
- **Last updated:** 10/01/2014