Healthcare Provider Details

I. General information

NPI: 1699149773
Provider Name (Legal Business Name): HOPE URGENT CARE JACKSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2015
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SUMMIT AVE
JACKSON MI
49201-2464
US

IV. Provider business mailing address

9171 LAPEER RD STE 100
DAVISON MI
48423-3617
US

V. Phone/Fax

Practice location:
  • Phone: 810-412-5590
  • Fax: 810-412-5593
Mailing address:
  • Phone: 810-412-5590
  • Fax: 810-412-5593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NUSRAT JAVAID
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 810-412-5590