Provider Demographics
NPI:1023241866
Name:MED SERVICE WALK-IN CLINIC P C
Entity type:Organization
Organization Name:MED SERVICE WALK-IN CLINIC P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:ASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-791-9173
Mailing Address - Street 1:PO BOX 1133
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-1133
Mailing Address - Country:US
Mailing Address - Phone:517-529-9266
Mailing Address - Fax:517-529-9277
Practice Address - Street 1:34336 HARPER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48035-3704
Practice Address - Country:US
Practice Address - Phone:586-791-9173
Practice Address - Fax:586-791-9373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJA029205261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E01410OtherBLUE CARE NETWORK