Organization
JAGANNATHAN NEUROSURGICAL INSTITUTE PLLC
Active
Parent organization
JAGANNATHAN NEUROSURGICAL INSTITUTE PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JAGANNATHAN NEUROSURGICAL INSTITUTE PLLC
Authorized official
JAYANT JAGANNATHAN (PRESIDENT)
(248) 733-9904
Entity
Organization
Contact information
Practice address
502 W HARRIE ST FL 2, NEWBERRY, MI 49868-1209
(989) 701-2538
(989) 701-2540
Mailing address
DEPT 771749 PO BOX 77000, DETROIT, MI 48277
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447299797
—
MI
Enumeration date
10/01/2018
Last updated
10/01/2018
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