Healthcare Provider Details

I. General information

NPI: 1689302945
Provider Name (Legal Business Name): FRANCIS G JOCIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5157 CARSON AVE SW
GRAND RAPIDS MI
49548-5647
US

IV. Provider business mailing address

5157 CARSON AVE SW
GRAND RAPIDS MI
49548-5647
US

V. Phone/Fax

Practice location:
  • Phone: 616-443-4698
  • Fax:
Mailing address:
  • Phone: 616-443-4698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: