IndividualActive
Jack Dekkinga, MD
NPI 1255365334 · MOHS-Micrographic Surgery Physician · Wyoming, MI
Provider details
- NPI number
- 1255365334
- Entity type
- Individual
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 4301039679 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1673 Gezon Pkwy Sw
Wyoming, MI 49519-9519
Phone: (616) 243-3376
Fax: (616) 243-3377
Approximate (ZIP-level) locationGet directions
Mailing address
1673 Gezon Pkwy Sw
Wyoming, MI 49519-9519
Registry dates
- Enumerated
- 2006-07-11
- Last updated
- 2022-02-22
- Certified
- 2022-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.