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Organization

JACKSON HEALTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARY L. JACKSON-HAMMOND M.D. (MEDICAL DIRECTOR)
(313) 831-8805
Entity
Organization

Contact information

Practice address
3800 WOODWARD AVE, STE. 418, DETROIT, MI 48201-2061
(313) 831-8805
(313) 832-8206
Mailing address
3800 WOODWARD AVE, STE. 418, DETROIT, MI 48201-2061
(313) 831-8805
(313) 832-8206

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4301046737
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4180604
MI
Enumeration date
07/17/2008
Last updated
07/17/2008
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