Jackson, Angela Kathryn
Jackson, Angela Kathryn is an individual health care provider with primary practice located at 647 Lime City Rd , Rossford OH 43460-1444. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Jackson, Angela Kathryn can be contacted via phone (419) 666-0700.Contact Information
Primary practice address
647 Lime City Rd
Rossford OH 43460-1444
Phone: (419) 666-0700
Fax: (419) 666-9605
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4846 | Ohio |
Profile Details
| NPI number | 1366435471 |
|---|---|
| LBN Legal business name | Jackson, Angela Kathryn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2005 |
| Last updated | May 20th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366435471 | NPPES |
| Ohio | Other | 03158 | PARAMOUNT |
| Ohio | Other | 000000185975 | PARAMOUNT |
| Ohio | Other | 5850518 | PARAMOUNT |
| Ohio | MEDICAID | 2051416 | PARAMOUNT |
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