Individual
GERALDINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 19401 HUBBARD DRIVE, DEARBORN, MI 48126
(313) 982-8330
(313) 982-8294
Mailing address
HENRY FORD HEALTH SYSTEM, 19401 HUBBARD DRIVE, DEARBORN, MI 48126
(313) 982-8330
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
056010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GJ056010
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
11/29/2006
Last updated
07/08/2007
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