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Contact Information

W.A. FOOTE MEMORIAL HOSPITAL, INC
205 N. EAST AVE
ATTN: PROVIDER ENROLLMENT
JACKSON, MI49201
 Phone: 517-841-7843
 Fax: 517-841-7419
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Hospice and Palliative Medicine

207RH0002X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for WA FOOTE MEMORIAL HOSPITAL INC · (Female)

NPI Number 1699212803
Status Active
Credentials
Entity Individual
Enumeration date 01/25/2017
Last updated 12/13/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 1060000044
  • MI Medicaid 1760437826
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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