Larry Jackson is a Family Medicine in Kalamazoo, Michigan. Larry Jackson practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Larry Jackson is 1720049349. The last update date is 2007-07-08.
Larry Jackson's current location address is 6565 W Main St, Kalamazoo, Michigan. You can contact this provider via phone number 2693750400 and fax number 2693728484. The mailing address for Larry Jackson is 6565 W Main St, Kalamazoo, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry Jackson |
|---|---|
| Address | 6565 W Main St, Kalamazoo, Michigan |
| Phone Number | 2693750400 |
| Fax Number | 2693728484 |
| Sole Proprietor | X |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1720049349 |
|---|---|
| Provider Enumeration Date | 2006-03-31 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 6565 W Main St |
|---|---|
| City | Kalamazoo |
| State | Michigan (MI) |
| Post Code | 490096114 |
| Phone Number | 2693750400 |
| Fax Number | 2693728484 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 4301062086 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4381907 | MI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Larry Jackson by the Centers for Medicare & Medicaid Services?
The Larry Jackson has been assigned the NPI (National Provider Identifier) 1720049349. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Larry Jackson's physical address?
The Larry Jackson is physically located at 6565 W Main St, in the city of Kalamazoo, MI, with the postal code 490096114.
What is Larry Jackson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Larry Jackson is Family Medicine, and the taxonomy classification code that categorizes this area of expertise is 207Q00000X.
On what date did the Larry Jackson receive the assignment of its 1720049349 from the Centers for Medicare & Medicaid Services?
The Larry Jackson was issued its 1720049349 by the Centers for Medicare & Medicaid Services on 2006-03-31.
As of what date were the details related to Larry Jackson most recently updated or revised?
The information pertaining to Larry Jackson, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
NPI Number: 1356344279
Address: Mount St. Mary's Hospital Laboratory, Lewiston, NY