<Unavail>

LBN: Ingrid W. Jackson, M.D., Llc
<Unavail> is an health care organization with primary practice located at 740 Signal Ridge Dr , Edmond OK 73013-3675. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Ingrid W. Jackson, M.D., Llc can be contacted via phone (405) 418-0125, or through White, Tina via phone (405) 418-0125.

Contact Information

Primary practice address
740 Signal Ridge Dr Edmond OK 73013-3675
Phone: (405) 418-0125
Fax: (405) 216-3454
Website:
Map and Directions
Authorized official contact:
Name: White, Tina
Phone: (405) 418-0125

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 15786 Oklahoma

Profile Details

NPI number 1205336187
LBN Legal business name Ingrid W. Jackson, M.D., Llc
DBA Doing business as <Unavail>
Authorized official White, Tina
Entity Organization
Organization subpart 1 No
Enumeration date Feb 16th, 2018
Last updated Oct 28th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205336187 NPPES
Oklahoma MEDICAID 100220060

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