Jackson, Alvin Deron

Jackson, Alvin Deron is an individual health care provider with primary practice located at 106 E Broad St , Savannah GA 31401-2917. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, Alvin Deron can be contacted via phone (912) 527-1000.

Contact Information

Primary practice address
106 E Broad St Savannah GA 31401-2917
Phone: (912) 527-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 066163 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35064673 Ohio

Profile Details

NPI number 1346228038
LBN Legal business name Jackson, Alvin Deron
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Jun 11th, 2019 - about 7 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 1346228038 NPPES
Georgia MEDICAID 003172519C

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