Organization
J T AILLS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J T AILLS M.D. (PRESIDENT)
(810) 230-7905
Entity
Organization
Contact information
Practice address
4448 OAKBRIDGE DR STE A, FLINT, MI 48532-5484
(810) 230-7905
(810) 230-7908
Mailing address
4448 OAKBRIDGE DR STE A, FLINT, MI 48532-5484
(810) 230-7905
(810) 230-7908
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
JA033988
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1498263
—
MI
Enumeration date
06/27/2007
Last updated
07/16/2009
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