Healthcare Provider Details

I. General information

NPI: 1033145826
Provider Name (Legal Business Name): JAMIE V FLOYD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13326 N BLVD
VICKSBURG MI
49097-1514
US

IV. Provider business mailing address

13326 N BLVD
VICKSBURG MI
49097-1514
US

V. Phone/Fax

Practice location:
  • Phone: 269-649-9136
  • Fax:
Mailing address:
  • Phone: 269-649-9136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number076760
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: