Healthcare Provider Details

I. General information

NPI: 1053403402
Provider Name (Legal Business Name): W.A. FOOTE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N EAST AVE
JACKSON MI
49201-1753
US

IV. Provider business mailing address

205 N EAST AVE
JACKSON MI
49201-1753
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-4800
  • Fax: 517-205-7419
Mailing address:
  • Phone: 517-788-4800
  • Fax: 517-796-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: ROBIN S. DAMSCHRODER
Title or Position: EVP, CHIEF FIN & BUS DEV OFFICER
Credential:
Phone: 313-876-8452