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General NPI Number Information
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NPI Number | 1508994211
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Entity Type | Organization
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Legal Business Name | JACKSON & BIGELOW MD PC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 400 JOSEPH DR STE B
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City | MIDLAND
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State | MI
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Zip | 48642-8636
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Country | US
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Telephone | 989-631-2020
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Fax | 989-835-6686
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Provider Business Mailing Address
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Address Line | 400 JOSEPH DR STE B
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City | MIDLAND
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State | MI
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Zip | 48642-8636
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Country | US
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Telephone | 989-631-2020
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Fax | 989-835-6686
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES LAWRENCE JACKSON
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Credential | M.D.
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Telephone | 989-631-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | MI
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