Jacob Charron, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fruitport, MI

NPI 1679416622 · NPPES record last updated Apr 13, 2026

Key facts

NPI
1679416622
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
3443 Farr Rd
Fruitport, MI 49415-8779
Phone
(231) 672-2900
NPI assigned
Apr 13, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI Yes

Addresses

Primary practice location

3443 Farr Rd
Fruitport, MI 49415-8779

Mailing address

3443 Farr Rd
Fruitport, MI 49415-8779
Phone (231) 672-2900

Other providers in Fruitport, MI

All providers in Fruitport, MI · Student in an Organized Health Care Education/Training Program in Michigan

Sources for this page

Verify at the official NPI Registry.