Individual
JOHN MACKSOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 HEALTH PARK BLVD, SUITE D, GRAND BLANC, MI 48439-2558
(810) 603-8400
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2007
(810) 743-1099
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
5101012207
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100013983
RR MEDICARE
MI
05
—
3474260
—
MI
Enumeration date
12/22/2005
Last updated
01/04/2010
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