Organization
PHS OF MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN CODY MD (STATE MEDICAL DIRECTOR)
(517) 827-3200
Entity
Organization
Contact information
Practice address
1780 E PARNALL RD, PARNALL CORRECTION FACILITY- MEDICAL CLINIC, JACKSON, MI 49201-7136
(517) 780-6393
Mailing address
6452 MILLENNIUM STE 100, LANSING, MI 48917-7881
(800) 207-9419
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4301094288
MI
Other
Enumeration date
07/03/2011
Last updated
07/03/2011
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