Jackson, Bryce V

Jackson, Bryce V is an sole proprietor health care provider with primary practice located at 1937 Harrison Ave , Panama City FL 32405-4543. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Jackson, Bryce V can be contacted via phone (850) 784-6877.

Contact Information

Primary practice address
1937 Harrison Ave Panama City FL 32405-4543
Phone: (850) 784-6877
Fax: (850) 785-5346
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME48532 Florida
Other Service Providers / Specialist 174400000X ME48532 Florida

Profile Details

NPI number 1467423632
LBN Legal business name Jackson, Bryce V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 27th, 2006
Last updated Sep 27th, 2011 - about 15 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 1467423632 NPPES
Florida MEDICAID 043532500
Florida Other 03638

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