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
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
1060000044
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760437826
—
MI
Enumeration date
01/25/2017
Last updated
03/06/2024
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