Organization
W.A. FOOTE MEMORIAL HOSPITAL, INC
Active
Parent organization
HENRY FORD ALLEGIANCE HEALTH GROUP
Other names
Henry Ford Allegiance Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
HENRY FORD ALLEGIANCE HEALTH GROUP
Authorized official
MARK SMITH (SVP, CMO, CEO)
(517) 205-6407
Entity
Organization
Contact information
Practice address
205 N. EAST AVE, JACKSON, MI 49201
(517) 841-7843
(517) 841-7419
Mailing address
PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267
(517) 841-7843
(517) 841-7419
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
1060000044
MI
2083P0901X
Public Health & General Preventive Medicine Physician
1060000044
MI
2083X0100X
Occupational Medicine Physician
Primary
1060000044
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760437826
—
MI
Enumeration date
01/30/2017
Last updated
03/06/2024
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