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Individual

JACOB RYAN COMPTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
19251 MACK AVE STE 333, GROSSE POINTE WOODS, MI 48236-2898
(313) 343-7280
Mailing address
22101 MOROSS RD STE 50, DETROIT, MI 48236-2172
(313) 343-7774

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101024103
MI
207R00000X
Internal Medicine Physician
Primary
5101026132
MI
390200000X
Student in an Organized Health Care Education/Training Program
5101024103
MI

Other

Enumeration date
06/18/2018
Last updated
06/28/2021
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