Organization · Type 2 NPI

W.a. Foote Memorial Hospital

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Jackson, MI

NPI number 1942740311 Active

Practice location

205 N East Ave
Jackson, MI 49201-1753

Call (517) 841-7843 Map

Fax (517) 841-7419

Mailing address

PO Box 670884, Department 272801
Detroit, MI 48267-0002

Specialties and licenses

Taxonomy	Code	License
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Primary	208G00000X	1060000044 (MI)

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician: A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of th…

620 other providers at this address

NPI record

NPI: 1942740311
Entity type: Organization (Type 2)
Issued: Mar 3, 2017
Last updated: Oct 20, 2026
Status: Active

Other names

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Henry Ford Allegiance Health · doing business as
Henry Ford Jackson Health · doing business as

Authorized official

Jody Roberts
Enrollment Specialist
(248) 641-6041

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1942740311

W.a. Foote Memorial Hospital's National Provider Identifier is 1942740311, issued on Mar 3, 2017. The primary taxonomy on file is Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (208G00000X), and the practice location is in Jackson, MI. The record was last updated on Oct 20, 2026.