MEDICARE: JAMES JACKSON D.O., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	5101004758	MI
2	207Q00000X	Family Medicine Physician	JJ004758	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619289642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES JACKSON D.O., P.C.

Provider Business Mailing Address
First Line	:	2416 PECK STREET
Second Line	:	JAMES JACKSON D.O., P.C.
City	:	MUSKEGON HTS.
State	:	MI
Zip	:	49444
Country	:	US
Telephone Number	:	231-739-5574
Fax Number	:	231-739-5574

Provider Business Practice Location Address
First Line	:	2416 PECK STREET
Second Line	:	JAMES JACKSON D.O., P.C.
City	:	MUSKEGON HTS.
State	:	MI
Zip	:	49444
Country	:	US
Telephone Number	:	231-739-5574
Fax Number	:	231-739-5574

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES JACKSON SR.
Credential	:	DO
Telephone Number	:	23173955574

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	10/08/2010

Similar Medicare Providers

1932106564 — DR. CHRISTIAN A PEABODY DDS
Practice Location Address:

2201 S. GETTY STREET
MUSKEGON HTS., MI
49444-1207

Practice Phone: 231-767-9830
Practice Fax: 231-773-2454

1588775175 — MARK A SHUNTA OD
Practice Location Address:

499 W NORTON AVE
MUSKEGON HTS, MI
49444

Practice Phone: 231-733-2685
Practice Fax: 231-737-1236

1316122153 — CO-OPTICAL EYE CARE EXPRESS INC.
Practice Location Address:

499 W NORTON AVE
MUSKEGON HTS, MI
49444-3727

Practice Phone: 231-733-2685
Practice Fax: 231-737-1236

1477791275 — JBC HOMES LLC
Practice Location Address:

2508 MCILWRAITH ST
MUSKEGON HTS, MI
49444-1633

Practice Phone: 231-737-0015
Practice Fax: 231-737-0015

1528430477 — MRS. JESSICA LEE VIDETICH RDH
Practice Location Address:

2700 BAKER ST
MUSKEGON HTS, MI
49444-2157

Practice Phone: 231-737-8603
Practice Fax:

1750827051 — DEANGELO JOHNSON SR.
Practice Location Address:

3309 LEMUEL ST
MUSKEGON HTS, MI
49444-2714

Practice Phone: 231-215-5047
Practice Fax:

Directions to “JAMES JACKSON D.O., P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.