Jackson, Bethany Wall

Jackson, Bethany Wall is an individual health care provider with primary practice located at 2112 Shorter Ave Nw Ste 240 , Rome GA 30165-2042. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Jackson, Bethany Wall can be contacted via phone (706) 368-8575.

Contact Information

Primary practice address
2112 Shorter Ave Nw Ste 240 Rome GA 30165-2042
Fax: (706) 204-9430
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 060642 Georgia

Profile Details

NPI number 1033396841
LBN Legal business name Jackson, Bethany Wall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2008
Last updated Apr 16th, 2024 - about 2 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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