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General NPI Number Information
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NPI Number | 1669569034
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Entity Type | Organization
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Legal Business Name | W. A. FOOTE MEMORIAL HOSPITAL, INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 700 E MICHIGAN AVE
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City | JACKSON
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State | MI
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Zip | 49201-1626
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Country | US
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Telephone | 517-768-8873
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Fax | 517-780-3816
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Provider Business Mailing Address
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Address Line | 700 E MICHIGAN AVE
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City | JACKSON
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State | MI
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Zip | 49201-1626
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Country | US
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Telephone | 517-768-8873
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Fax | 517-780-3816
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Authorized Official
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Title or Position | SVP CEO
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Name | MARK SMITH
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Credential | M.D.
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Telephone | 313-874-4806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 380010
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License Number State | MI
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