Burgess, Jacques

Burgess, Jacques is an individual health care provider with primary practice located at 1105 Sixth St , Traverse City MI 49684-2345. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Burgess, Jacques can be contacted via phone (231) 935-5000.

Contact Information

Primary practice address
1105 Sixth St Traverse City MI 49684-2345
Phone: (231) 935-5000
Fax: (231) 346-6017
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301070541 Michigan
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301070541 Michigan

Profile Details

NPI number 1174549802
LBN Legal business name Burgess, Jacques
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Aug 16th, 2019 - about 7 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 1174549802 NPPES
Michigan MEDICAID 4234840
Michigan MEDICAID 4324722

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