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:
Health care specialties
| Specialty | Code | License # | 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 13 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 | 1477606614 | NPPES |
| Michigan | Other | 16789 | HEALTH PLAN OF MICHIGAN |
| Michigan | MEDICAID | 4733213 | HEALTH PLAN OF MICHIGAN |
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