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Organization
W. A. FOOTE MEMORIAL HOSPITAL, INC
Active
Organization
W. A. FOOTE MEMORIAL HOSPITAL, INC
Active
Other names
Henry Ford Jackson Health, Allegiance Health, Henry Ford Health Jackson Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY RATOWSKI (VP PROVIDER AFFAIRS)
(313) 874-4806
Entity
Organization
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4800
Mailing address
PO BOX 670884, DETROIT, MI 48267-2728
(800) 999-5829
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
MI
363A00000X
Physician Assistant
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700C810580
BCBSM DOCTORS
MI
01
—
CC5829
RR MEDICARE
MI
Enumeration date
05/24/2006
Last updated
04/07/2026
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