Jack R. Roossien Jr., M.D.P.C.

LBN: Jack R. Roossien Jr., M.D.P.C.
Jack R. Roossien Jr., M.D.P.C. is an health care organization with primary practice located at 15151 Stanton St Suite A, West Olive MI 49460-8543. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Jack R. Roossien Jr., M.D.P.C. can be contacted via phone (616) 296-1020, or through Roossien, Jack Richard via phone (616) 296-1020.

Contact Information

Primary practice address
15151 Stanton St Suite A West Olive MI 49460-8543
Fax: (616) 296-1030
Website:
Authorized official contact:
Name: Roossien, Jack Richard Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301050437 Michigan

Profile Details

NPI number 1740406982
LBN Legal business name Jack R. Roossien Jr., M.D.P.C.
DBA Doing business as
Authorized official Roossien, Jack Richard Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 17th, 2007
Last updated May 27th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740406982 NPPES
Michigan Other ON13120 MEDICARE GROUP NUMBER
Michigan MEDICAID 4214810 MEDICARE GROUP NUMBER

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