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
Phone: (706) 368-8575
Fax: (706) 204-9430
Website:
Health care specialties
| Specialty | Code | License # | 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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