Provider Demographics
NPI:1366629214
Name:SAVAGE, JOSEPH SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SCOTT
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N ALPINE LAKE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-6334
Mailing Address - Country:US
Mailing Address - Phone:517-416-3730
Mailing Address - Fax:
Practice Address - Street 1:400 N ALPINE LAKE DR
Practice Address - Street 2:SUITE F
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-6334
Practice Address - Country:US
Practice Address - Phone:517-416-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004655207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG79979Medicare UPIN
TN3300040Medicare PIN