Flack, Ronald J

Flack, Ronald J is an individual health care provider with primary practice located at 762 W Michigan Ave , Jackson MI 49201-1978. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Flack, Ronald J can be contacted via phone (517) 782-8142.

Contact Information

Primary practice address
762 W Michigan Ave Jackson MI 49201-1978
Phone: (517) 782-8142
Fax: (517) 782-0765
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704149271 Michigan

Profile Details

NPI number 1477606614
LBN Legal business name Flack, Ronald J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2007
Last updated Aug 16th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477606614 NPPES
Michigan Other 16789 HEALTH PLAN OF MICHIGAN
Michigan MEDICAID 4733213 HEALTH PLAN OF MICHIGAN

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