Provider Demographics
NPI:1174103584
Name:MORTON, JACOB MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:MICHAEL
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD # 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1952
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6770
Practice Address - Country:US
Practice Address - Phone:248-551-3000
Practice Address - Fax:248-551-4784
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2024-07-14
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Provider Licenses
StateLicense IDTaxonomies
MI4351047719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine