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General NPI Number Information
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NPI Number | 1255306429
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Entity Type | Individual
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Provider Name | JOHN AXELSON MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 1100 E MICHIGAN AVE STE 201
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City | JACKSON
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State | MI
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Zip | 49201-1847
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Country | US
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Telephone | 517-789-7122
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Fax | 517-789-5229
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Provider Business Mailing Address
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Address Line | 150 HAWTHORNE DR
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City | BROOKLYN
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State | MI
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Zip | 49230-8924
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Country | US
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Telephone | 517-592-8984
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | JA037999
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License Number State | MI
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