MEDICARE: DR. JOHN ARGYLE SAMPSON MD

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
1	208600000X	Surgery Physician	ME121890	FL
2	208600000X	Surgery Physician	4301049181	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13-20001	OTHER	MI	PHP
2	24-0380695-2	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1376626853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ARGYLE SAMPSON MD

Provider Business Mailing Address
First Line	:	1514 4TH ST
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-4032
Country	:	US
Telephone Number	:	517-780-0080
Fax Number	:	517-780-0043

Provider Business Practice Location Address
First Line	:	1514 4TH ST
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-4032
Country	:	US
Telephone Number	:	517-780-0080
Fax Number	:	517-780-0043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	03/25/2026

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