Individual
DR. JAMES PHILIP SERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
350 N WISNER ST, JACKSON, MI 49202-4225
(517) 783-6928
Mailing address
3695 W PRIMILIA LN, JACKSON, MI 49201-9395
(517) 783-3916
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003057
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000004902
PHP OF SOUTH MICHIGAN
MI
01
—
410020815
PALMETTO GBA RR MEDICARE
MI
01
—
5448465
AETNA
MI
01
—
5892950001
DMERC
MI
01
—
900C811800
BCBS OF MICHIGAN
MI
01
—
VCM-0142
M-CARE
MI
Enumeration date
11/02/2005
Last updated
02/17/2017
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