Organization
CHAD J. JACKSON, OD, PLLC
Active
Other names
Bella Vista Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD J. JACKSON OD (SOLE MEMBER/OWNER)
(616) 874-2020
Entity
Organization
Contact information
Practice address
6575 BELDING RD NE, SUITE D, ROCKFORD, MI 49341-7418
(616) 874-2020
(616) 874-2773
Mailing address
6575 BELDING RD NE, SUITE D, ROCKFORD, MI 49341-7418
(616) 874-2020
(616) 874-2773
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003954
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4925900
—
MI
Enumeration date
01/28/2008
Last updated
11/26/2018
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