Organization
W.A. FOOTE MEMORIAL HOSPITAL, INC
Active
Parent organization
HENRY FORD JACKSON HEALTH
Other names
Henry Ford Allegiance Health, Henry Ford Jackson Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
HENRY FORD JACKSON HEALTH
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization
Contact information
Practice address
205 N. EAST AVE, ATTN: PROVIDER ENROLLMENT, JACKSON, MI 49201
(517) 841-7843
(517) 841-7419
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(800) 999-5829
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
1060000044
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760437826
—
MI
Enumeration date
01/30/2017
Last updated
01/21/2026
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