Frederick P Jaecklein
Internist Hematologist
1414 W. Fair Avenue Ste 201
Marquette
, Michigan 49855
Frederick P Jaecklein
Internist Hematologist
1414 W. Fair Avenue Ste 201
Marquette
, Michigan 49855
(916) 920-8775
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About
Features
Specialties
- Internist
- Hematologist
Languages spoken
- English
Location
First Address
- Frederick P Jaecklein
- 330 Seven Springs Way
- Brentwood, TN
- Zip : 37027-5098
- Fax : (916) 920-8775
- Phone : (615) 920-7000
Second Address
- Frederick P Jaecklein
- 1414 W. Fair Avenue Ste 201
- Marquette, MI
- Zip : 49855
- Fax : (906) 225-3919
- Phone : (906) 225-4500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 049842 | MI |
| Y | 111NI0900X | Internist | 049842 | MI |
| N | 207RH0000X | Hematologist | 049842 | MI |
National Provider Identifier
| NPI | 1306828009 |
|---|---|
| Provider Name | Frederick P Jaecklein |
| First Address | Brentwood, TN 37027-5098 |
| Second Address | Marquette, MI 49855 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/11/2005 |
| Last Update Date | 04/06/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110030846 | RAILROAD MEDICARE (01) | MI |
| 3138366 | (05) | MI |
| 381358036011 | TRICARE (01) | MI |
| B47074 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.