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MARK A JACKSON MD PLC

Geriatric Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

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Contact Information

MARK A JACKSON MD PLC
1000 PAVILLIONS CIR
TRAVERSE CITY, MI  49684-3198
 Phone: 231-935-0913
 Fax: 231-935-0984
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

 207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MARK A JACKSON MD PLC

NPI # 1740439025
LBN Legal business name MARK A JACKSON MD PLC
Authorized official MARK JACKSON - (PHYSICIAN/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/11/2008
Last updated 12/18/2008 - About 17 years ago
Identifiers
MI License # 4301051555
MI Medicaid 1073585238
MI Other 0B81350 BCBS GROUP ID#
MI Other 080B813500 BCBS ID#
MI Other 0802802421 BCBS PIN#
MI Other 1740439025 GROUP NPI
MI Other 1073585238 IND NPI
MI Other 0MI1114 MEDICARE GROUP
MI Other MI1114001 MEDICARE IND PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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