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NPI Code Detail

MEDICARE: VALERIE PAYNE-JACKSON DO

MEDICARE: VALERIE PAYNE-JACKSON DO
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
1207V00000XObstetrics & Gynecology PhysicianVP008011MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942294947
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE PAYNE-JACKSON DO
Provider Business Mailing Address
First Line : 1812 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-3532
Country : US
Telephone Number : 248-656-9100
Fax Number : 248-656-9157
Provider Business Practice Location Address
First Line : 1812 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-3532
Country : US
Telephone Number : 248-656-9100
Fax Number : 248-656-9157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 09/18/2007

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Directions to “ VALERIE PAYNE-JACKSON DO” Practice Location

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