Jackson, Allen B

Jackson, Allen B is an sole proprietor health care provider with primary practice located at 8761 Dorchester Rd Ste 100 , North Charleston SC 29420-7320. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Jackson, Allen B can be contacted via phone (843) 767-3323.

Contact Information

Primary practice address
8761 Dorchester Rd Ste 100 North Charleston SC 29420-7320
Phone: (843) 767-3323
Fax: (843) 767-4252
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 13680 South Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 13680 South Carolina

Profile Details

NPI number 1902866965
LBN Legal business name Jackson, Allen B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2006
Last updated Nov 3rd, 2023 - about 3 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 1902866965 NPPES
South Carolina MEDICAID GP6738
South Carolina MEDICAID 136800

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