Provider Demographics
NPI:1326007360
Name:SMARCH, JOHN F (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:SMARCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W WASHINGTON AVE
Mailing Address - Street 2:STE 250
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2160
Mailing Address - Country:US
Mailing Address - Phone:517-787-4513
Mailing Address - Fax:517-787-6943
Practice Address - Street 1:300 W WASHINGTON AVE STE 250
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2160
Practice Address - Country:US
Practice Address - Phone:517-787-4513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00229475OtherRAILROAD MEDICARE
MI950C811280OtherBLUE CROSS BLUE SHIELD
MIP00229475OtherRAILROAD MEDICARE
MI0P19810Medicare ID - Type Unspecified