Healthcare Provider Details
I. General information
NPI: 1194640425
Provider Name (Legal Business Name): HOME VISIT MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2634 WILLIAMSBURG CIR
AUBURN HILLS MI
48326-4150
US
IV. Provider business mailing address
2634 WILLIAMSBURG CIR
AUBURN HILLS MI
48326-4150
US
V. Phone/Fax
- Phone: 615-499-3165
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
JOKERST
Title or Position: PRESIDENT
Credential: DO
Phone: 615-499-3165