Organization
JOANNE KINGSLEY MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE RUTH KINGSLEY M.D. (PRESIDENT/OWNER)
(517) 796-4775
Entity
Organization
Contact information
Practice address
1931 HORTON RD, SUITE 8, JACKSON, MI 49203-5594
(517) 782-7510
(517) 782-7520
Mailing address
1931 HORTON RD, SUITE 8, JACKSON, MI 49203-5594
(517) 782-7510
(517) 782-7520
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0720045
PHP PROVIDER NUMBER
MI
05
—
104778547
—
MI
01
—
1603811241
BCBS PROVIDER NUMBER
MI
Enumeration date
11/01/2006
Last updated
07/24/2008
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