Individual
MR. RONALD J FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
762 W MICHIGAN AVE, JACKSON, MI 49201-1978
(517) 782-8142
(517) 782-0765
Mailing address
762 W MICHIGAN AVE, JACKSON, MI 49201-1978
(517) 782-8142
(517) 782-0765
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704149271
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16789
HEALTH PLAN OF MICHIGAN
MI
05
—
4733213
—
MI
Enumeration date
01/19/2007
Last updated
08/16/2012
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