Ian T. Jackson, M.d.

NPI #1649310632 in Novi, Michigan

Provider Information

NPI Number
1649310632
Entity Type
Organization
Organization Name
Ian T. Jackson, M.d.
Primary Specialty
Clinic/Center - Medical Specialty
Enumeration Date
Feb 7, 2007
Last Updated
Mar 22, 2010

Practice Location

Address
26850 PROVIDENCE PKWY
Address 2
STE 205
City
Novi
ZIP Code
48374-1213
Phone
(248) 465-5300

Authorized Official

Name
DR. IAN THOMAS JACKSON, M.D.
Title
PHYSICANDIRECTOR
Phone
(248) 465-5300

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Medical SpecialtyMedical Specialty

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