Provider Demographics
NPI:1003818022
Name:DARMON, JACQUES GERARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:JACQUES
Middle Name:GERARD
Last Name:DARMON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250133
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-0133
Mailing Address - Country:US
Mailing Address - Phone:248-670-2733
Mailing Address - Fax:248-855-8663
Practice Address - Street 1:26900 CRESTWOOD DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MI
Practice Address - Zip Code:48025-1378
Practice Address - Country:US
Practice Address - Phone:248-670-2733
Practice Address - Fax:248-855-8663
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001485213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2619793Medicaid
MI480021978OtherRAILROAD MEDICARE
MI5630826OtherBCBS PIN
MIXX15205OtherHEALTH PLUS
MIP68955OtherBCN
MI480021978OtherRAILROAD MEDICARE
MIP68955OtherBCN
5635429Medicare ID - Type Unspecified