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General NPI Number Information
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NPI Number | 1518201920
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Entity Type | Organization
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Legal Business Name | EUGENE D ROHACZ D P M P C
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 1518 W MICHIGAN AVE
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City | JACKSON
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State | MI
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Zip | 49202-4025
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Country | US
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Telephone | 517-780-7780
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Fax | 517-437-0372
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Provider Business Mailing Address
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Address Line | 1518 W MICHIGAN AVE
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City | JACKSON
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State | MI
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Zip | 49202-4025
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Country | US
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Telephone | 517-780-7780
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Fax | 517-437-0372
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Authorized Official
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Title or Position | OWNER
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Name | DR. EUGENE D ROHACZ
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Credential | D.P.M.
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Telephone | 517-780-7880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5901001700
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License Number State | MI
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