Provider Demographics
NPI:1992974018
Name:VISITING DOCTORS PC
Entity type:Organization
Organization Name:VISITING DOCTORS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJOVI
Authorized Official - Middle Name:BLESSING
Authorized Official - Last Name:SCOTT-EMUAKPOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-788-9700
Mailing Address - Street 1:PO BOX 1002
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-1002
Mailing Address - Country:US
Mailing Address - Phone:517-879-1007
Mailing Address - Fax:517-784-8975
Practice Address - Street 1:2108 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-4518
Practice Address - Country:US
Practice Address - Phone:517-788-9700
Practice Address - Fax:517-784-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty