Healthcare Provider Details

I. General information

NPI: 1801688866
Provider Name (Legal Business Name): DAMIEN SKEYE HONECK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W FRANKLIN ST
JACKSON MI
49201-2148
US

IV. Provider business mailing address

330 W FRANKLIN ST
JACKSON MI
49201-2148
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-7573
  • Fax: 517-395-4206
Mailing address:
  • Phone: 517-787-7573
  • Fax: 517-395-4206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: