Jackson, Charity L
Jackson, Charity L is an individual health care provider with primary practice located at 402 N Tejon St Ste 200 , Colorado Springs CO 80903. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Jackson, Charity L can be contacted via phone (719) 633-3850.Contact Information
Primary practice address
402 N Tejon St Ste 200
Colorado Springs CO 80903
Phone: (719) 633-3850
Fax: (719) 227-0840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | DR.0059719 | Colorado |
Profile Details
| NPI number | 1033382262 |
|---|---|
| LBN Legal business name | Jackson, Charity L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 9th, 2008 |
| Last updated | Jun 14th, 2018 - about 8 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 | 1033382262 | NPPES |
| Texas | MEDICAID | 283583701 | |
| Texas | MEDICAID | 283583702 |
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