# WA FOOTE MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WA FOOTE MEMORIAL HOSPITAL
- **Other names:** ON HOLD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962579227
- **Legal business name:** WA FOOTE MEMORIAL HOSPITAL
- **Authorized official:** MARK SMITH CFO (SVP, CMO)
- **Authorized official phone:** (517) 205-6407

## Contact information

- **Practice address:** 205 N EAST AVE, JACKSON, MI 49201-1753
- **Practice address phone:** (517) 788-4800
- **Mailing address:** PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-2728
- **Mailing address phone:** (517) 841-6913
- **Mailing address fax:** (517) 841-6917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | MI | Yes |

## Other

- **Enumeration date:** 11/29/2006
- **Last updated:** 03/06/2024