Jacks, Alan Fowler

Jacks, Alan Fowler is an individual health care provider with primary practice located at 845 Malcolm Blvd. , Connelly Springs NC 28612. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jacks, Alan Fowler can be contacted via phone (828) 580-3555.

Contact Information

Primary practice address
845 Malcolm Blvd. Connelly Springs NC 28612
Phone: (828) 580-3555
Fax: (828) 874-2111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 9601640 North Carolina

Profile Details

NPI number 1992987713
LBN Legal business name Jacks, Alan Fowler
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2007
Last updated May 23rd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992987713 NPPES
North Carolina MEDICAID 1992987713
North Carolina MEDICAID 891013E

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