Jack A Dekkinga Md Pc in Grandville - Specialist
Jack A Dekkinga Md Pc - NPI 1609896034
Jack A Dekkinga Md Pc is a Specialist in Grandville, Michigan. Jack A Dekkinga Md Pc practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jack A Dekkinga Md Pc is 1609896034. The last update date is 2022-04-13.
Jack A Dekkinga Md Pc's current location address is 3434 Rivertown Point Ct Sw, Grandville, Michigan. You can contact this provider via phone number 6162573344 and fax number 6162571491. The mailing address for Jack A Dekkinga Md Pc is 3434 Rivertown Point Ct Sw, Grandville, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jack A Dekkinga Md Pc |
|---|---|
| Address | 3434 Rivertown Point Ct Sw, Grandville, Michigan |
| Phone Number | 6162573344 |
| Fax Number | 6162571491 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Ang Charlene Gina |
| Credentials | MD |
| Telephone Number | 6162573344 |
NPI Number Detail
| NPI Number | 1609896034 |
|---|---|
| Provider Enumeration Date | 2006-07-20 |
| Last Updated Date | 2022-04-13 |
Provider Mailing Address Detail
| Address | 3434 Rivertown Point Ct Sw |
|---|---|
| City | Grandville |
| State | Michigan (MI) |
| Post Code | 494183076 |
| Phone Number | 6162573344 |
| Fax Number | 6162571491 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 4301039679 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CI2832 | NV | MEDICARE RAILROAD GROUP | |
| 070D16223 | MI | BCBS OF MICHIGAN | |
| 0N86210 | MI | MEDICARE GROUP NUMBER |
Post Comment/ Review Below
What is the Jack A Dekkinga Md Pc's 1609896034?
The Jack A Dekkinga Md Pc's NPI (National Provider Identifier) Number is 1609896034. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jack A Dekkinga Md Pc's physical address?
The Jack A Dekkinga Md Pc is physically located at 3434 Rivertown Point Ct Sw, in the city of Grandville, MI, with the postal code 494183076.
What is the Jack A Dekkinga Md Pc's area of specialization and corresponding taxonomy classification?
The Jack A Dekkinga Md Pc's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
When did Jack A Dekkinga Md Pc receive its 1609896034 assignment?
The Jack A Dekkinga Md Pc was assigned its 1609896034 on 2006-07-20, which is the date when this unique identifier was issued to the organization.
When was the information regarding Jack A Dekkinga Md Pc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Jack A Dekkinga Md Pc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2022-04-13.