Jacqueleen Marie Magon, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301048989 Issued in MI

Practice address

1200 Byron Rd
Howell, MI 48843-1007

Phone

(517) 546-0200

Fax

(517) 546-4669

NPI assigned

Jun 1, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jacqueleen Marie Vaclavek Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1992742464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BYRON RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431007",
            "telephone_number": "517-546-0200",
            "fax_number": "517-546-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BYRON RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431007",
            "telephone_number": "517-546-0200",
            "fax_number": "517-546-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGON",
        "first_name": "JACQUELEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301048989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELEEN",
            "last_name": "VACLAVEK",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Howell, MI
• Providers in Howell, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.