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NPI Code Detail

MEDICARE: JACKSON RADIOLOGY CONSULTANTS, P C

MEDICARE: JACKSON RADIOLOGY CONSULTANTS, P C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMI

General Provider Information

NPI Number : 1295736015
Entity Type Code : Organization
Provider Name (Legal Business Name) : JACKSON RADIOLOGY CONSULTANTS, P C
Provider Business Mailing Address
First Line : 2800 SPRING ARBOR RD STE 102
Second Line : PO BOX 905
City : JACKSON
State : MI
Zip : 49203-3895
Country : US
Telephone Number : 517-783-2612
Fax Number : 517-783-5991
Provider Business Practice Location Address
First Line : 205 N EAST AVE
Second Line : IMAGING DEPARTMENT
City : JACKSON
State : MI
Zip : 49201-1753
Country : US
Telephone Number : 517-783-2612
Fax Number : 517-783-5991
Authorized Official
Title or Position : PRESIDENT
Name : PIYUSH C PATEL
Credential : M.D.
Telephone Number : 517-783-2612
Provider Enumeration Date : 08/02/2005
Last Update Date : 02/02/2024

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1447251194 — BHASKAR U SHENAI M.D.
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1831190461 — RENUKA M PATEL M.D.
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1770584948 — PIYUSH C PATEL M.D.
Practice Location Address:
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Practice Fax: 517-783-5991

Directions to “JACKSON RADIOLOGY CONSULTANTS, P C ” Practice Location

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