Organization · Type 2 NPI

W.a. Foote Memorial Hospital

Family Medicine Physician · Jackson, MI

NPI number 1962953034 Active

Practice location

205 N East Ave
Jackson, MI 49201-1753

Call (517) 205-7843 Map

Mailing address

PO Box 670884
Detroit, MI 48267-0884

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	1060000044 (MI)
Sports Medicine (Family Medicine) Physician	207QS0010X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

620 other providers at this address

Other family medicine physician providers in Jackson

See all in Jackson →

NPI record

NPI: 1962953034
Entity type: Organization (Type 2)
Issued: Oct 24, 2016
Last updated: Oct 20, 2026
Status: Active

Other names

<unavail>
Henry Ford Allegiance Health · doing business as
Henry Ford Jackson Health · doing business as

Authorized official

Kimberly Cebalt
Director
(313) 874-6764

Verify this record

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.

Is this your record? How to update it.

About NPI 1962953034

W.a. Foote Memorial Hospital's National Provider Identifier is 1962953034, issued on Oct 24, 2016. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Jackson, MI. The record was last updated on Oct 20, 2026.