# JACKSON FAMILY MEDICAL

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

## Provider details

- **NPI number:** 1972873800
- **Authorized official:** MRS. TAMMY L CREGER (BILLING SPECIALIST)
- **Authorized official phone:** (517) 783-2696

## Contact information

- **Practice address:** 724 W FRANKLIN ST, JACKSON, MI 49201-2008
- **Practice address phone:** (517) 784-3100
- **Practice address fax:** (517) 784-3200
- **Mailing address:** 724 W FRANKLIN ST, JACKSON, MI 49201-2008
- **Mailing address phone:** (517) 784-3100
- **Mailing address fax:** (517) 784-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | GL010466 | MI | — |
| 207R00000X | Internal Medicine Physician | JA011504 | MI | — |
| 208D00000X | General Practice Physician | GL010466 | MI | Yes |

## Other

- **Enumeration date:** 01/10/2012
- **Last updated:** 01/10/2012