Healthcare Provider Details

I. General information

NPI: 1992974018
Provider Name (Legal Business Name): VISITING DOCTORS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 4TH ST STE A
JACKSON MI
49203-4518
US

IV. Provider business mailing address

PO BOX 1002
JACKSON MI
49204-1002
US

V. Phone/Fax

Practice location:
  • Phone: 517-788-9700
  • Fax: 517-784-8975
Mailing address:
  • Phone: 517-879-1007
  • Fax: 517-784-8975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. AJOVI BLESSING SCOTT-EMUAKPOR
Title or Position: OWNER
Credential: M.D.
Phone: 517-788-9700