Healthcare Provider Details

I. General information

NPI: 1376626853
Provider Name (Legal Business Name): JOHN ARGYLE SAMPSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 4TH ST
JACKSON MI
49203-4032
US

IV. Provider business mailing address

1514 4TH ST
JACKSON MI
49203-4032
US

V. Phone/Fax

Practice location:
  • Phone: 517-780-0080
  • Fax: 517-780-0043
Mailing address:
  • Phone: 517-780-0080
  • Fax: 517-780-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301JS049181
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: