Jackson, Carole Lynn
Jackson, Carole Lynn is an individual health care provider with primary practice located at 525 Western Avenue Suite 303, Conway AR 72034-6135. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Jackson, Carole Lynn can be contacted via phone (501) 327-9497.Contact Information
Primary practice address
525 Western Avenue Suite 303
Conway AR 72034-6135
Phone: (501) 327-9497
Fax: (501) 327-3478
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | C 5812 | Arkansas |
Profile Details
| NPI number | 1427020882 |
|---|---|
| LBN Legal business name | Jackson, Carole Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2006 |
| Last updated | Mar 7th, 2023 - about 3 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 | 1427020882 | NPPES |
| Arkansas | MEDICAID | 113505001 |
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