Dekkinga, Jack A
Dekkinga, Jack A is an individual health care provider with primary practice located at 1673 Gezon Pkwy Sw , Wyoming MI 49519-9519. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Dekkinga, Jack A can be contacted via phone (616) 243-3376.Contact Information
Primary practice address
1673 Gezon Pkwy Sw
Wyoming MI 49519-9519
Phone: (616) 243-3376
Fax: (616) 243-3377
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 4301039679 | Michigan |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 5601039679 | Michigan |
Profile Details
| NPI number | 1255365334 |
|---|---|
| LBN Legal business name | Dekkinga, Jack A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Feb 22nd, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255365334 | NPPES |
| Michigan | Other | 070D16223 | BCBS MI |
| Michigan | Other | DX9137 | BCBS MI |
| Michigan | MEDICAID | 1255365334 | BCBS MI |
| Michigan | Other | MI11296 | BCBS MI |
Popular Providers
-
Gerondale, Brian J
1740 E Paris Ave Se , Grand Rapids MI 49546-6204 -
Beer, Kenneth
1500 N Dixie Hwy Suite 305, West Palm Beach FL 33401-2712 -
Payne, Joseph R
Dermatology Associates Of Atlanta, Pc 5555 Peachtree Dunwoody Road Ne Suite 190, Atlanta GA 30342-1710 -
Ceballos, Patricia I
1673 Gezon Pkwy Sw , Wyoming MI 49519-9519 -
Miner, John E
1740 E Paris Ave Se , Grand Rapids MI 49546-6204 -
Hodson, Darryl Dhaw
212 Hospital Dr Suite C, Warner Robins GA 31088-4207 -
Rhinehart, Brandon
13100 N Western Ste 301, Oklahoma City OK 73114-1670 -
Carter, Westley A
702 Nw Sheridan Rd , Lawton OK 73505-5203