Unknown Individual – Obstetrics & Gynecology Physician, NPI 1912974783

Unknown Individual is a healthcare provider. based in Jackson, Michigan. specializing in Obstetrics & Gynecology Physician. They hold a License No. GS052164 (MI). The NPI Number for Unknown Individual is 1912974783

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1912974783
Phone
(517) 787-0072
Address
1100 E MICHIGAN AVE
Deactivation Date
22 February 2023

Doctor Profile

Medical School Name
UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Secondary Phone
5177870072
Graduation Year
1979 (47 years ago)
PAC ID
3678765096
Professional Enrollment ID
I20101004001252
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1100, Michigan Avenue, Jackson Heights, Muscle Shoals, Colbert County, Alabama, 35661, United States

    SUITE 204

    JACKSON, MI 492011847

    Phone: (517) 787-0072

    Fax: (517) 787-1988

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49201)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1912974783.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Jackson, Michigan may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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