Michaelis Jackson & Associates, LLC

NPI #1144387333 in Herrin, Illinois

Provider Information

NPI Number: 1144387333
Entity Type: Organization
Organization Name: Michaelis Jackson & Associates, LLC
Primary Specialty: Ophthalmology
Enumeration Date: Jan 3, 2007
Last Updated: Sep 7, 2007

Practice Location

Address: 500 LINCOLN DR
Address 2: SUITE A
City: Herrin
State: Illinois
ZIP Code: 62948-6334
Phone: (618) 351-8900

Authorized Official

Name: DR. MICHAELIS JACKSON, MD
Title: PRESIDENT
Phone: (618) 351-8900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Ophthalmology	207W00000X	Primary

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