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Organization
IEP OBSERVATION MEDICINE - JACKSON PLLC
Active
Organization
IEP OBSERVATION MEDICINE - JACKSON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GERALD HALL MD (MANAGER)
(248) 536-2127
Entity
Organization
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(248) 536-2127
(248) 893-6952
Mailing address
PO BOX 675472, DETROIT, MI 48267-5472
(248) 536-2127
(248) 893-6952
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
05/08/2025
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