Jack A Dekkinga in Wyoming - Mohs-micrographic Surgery
Jack A Dekkinga - NPI 1255365334
Jack A Dekkinga is a Mohs-micrographic Surgery in Wyoming, Michigan. Jack A Dekkinga practices all healthcare services and medical treatments related to Mohs-micrographic Surgery. The NPI Number for Jack A Dekkinga is 1255365334. The last update date is 2022-02-22.
Jack A Dekkinga's current location address is 1673 Gezon Pkwy Sw, Wyoming, Michigan. You can contact this provider via phone number 6162433376 and fax number 1624333776. The mailing address for Jack A Dekkinga is 1673 Gezon Pkwy Sw, Wyoming, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack A Dekkinga |
|---|---|
| Address | 1673 Gezon Pkwy Sw, Wyoming, Michigan |
| Phone Number | 6162433376 |
| Fax Number | 1624333776 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1255365334 |
|---|---|
| Provider Enumeration Date | 2006-07-11 |
| Last Updated Date | 2022-02-22 |
Provider Mailing Address Detail
| Address | 1673 Gezon Pkwy Sw |
|---|---|
| City | Wyoming |
| State | Michigan (MI) |
| Post Code | 495199519 |
| Phone Number | 6162433376 |
| Fax Number | 1624333776 |
Provider's Primary Taxonomy Detail
| Speciality | Mohs-micrographic Surgery |
|---|---|
| Taxonomy | 207Nd0101X |
| Licence No | 5601039679 |
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Definition: The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 070D16223 | MI | BCBS MI | |
| DX9137 | MEDICARE RR GROUP | ||
| 1255365334 | MI | -- | |
| MI11296 | MEDICARE PTAN GROUP |
Post Comment/ Review Below
What is the unique identifier code issued to Jack A Dekkinga by the Centers for Medicare & Medicaid Services (CMS)?
The Jack A Dekkinga has been assigned the NPI (National Provider Identifier) 1255365334. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Jack A Dekkinga?
The Jack A Dekkinga is situated at 1673 Gezon Pkwy Sw, in the city of Wyoming, state of MI, with the zip code 495199519.
What is Jack A Dekkinga's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Jack A Dekkinga is Mohs-micrographic Surgery, and the taxonomy code that categorizes this field of expertise is 207Nd0101X.
When was the Jack A Dekkinga's 1255365334 issued?
The Jack A Dekkinga's 1255365334 was issued on 2006-07-11.
As of what date was the information pertaining to Jack A Dekkinga, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jack A Dekkinga, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2022-02-22.