# W.A. FOOTE MEMORIAL HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HENRY FORD ALLEGIANCE HEALTH GROUP
- **Other names:** Henry Ford Allegiance Health
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710424908
- **Legal business name:** HENRY FORD ALLEGIANCE HEALTH GROUP
- **Authorized official:** MARK SMITH (SVP, CMO, CEO)
- **Authorized official phone:** (517) 205-6407

## Contact information

- **Practice address:** 205 N. EAST AVE, JACKSON, MI 49201
- **Practice address phone:** (517) 841-7843
- **Practice address fax:** (517) 541-7419
- **Mailing address:** PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267
- **Mailing address phone:** (517) 841-7843
- **Mailing address fax:** (517) 841-7419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086H0002X | Hospice and Palliative Medicine (Surgery) Physician | 1060000044 | MI | Yes |

## Other

- **Enumeration date:** 01/25/2017
- **Last updated:** 03/06/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1760437826 | — | MI |