Jackson, Daniel Mark

Jackson, Daniel Mark is an sole proprietor health care provider with primary practice located at 713 N 114Th St , Omaha NE 68154-1515. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jackson, Daniel Mark can be contacted via phone (402) 991-3131.

Contact Information

Primary practice address
713 N 114Th St Omaha NE 68154-1515
Phone: (402) 991-3131
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 960 Nebraska

Profile Details

NPI number 1972502391
LBN Legal business name Jackson, Daniel Mark
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2005
Last updated Jun 1st, 2016 - about 9 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 1972502391 NPPES
Nebraska Other 37154 BCBS
Nebraska MEDICAID 10025388500 BCBS
Nebraska Other P00393695 BCBS
Nebraska Other 904415 BCBS
Nebraska MEDICAID 10025583800 BCBS
Nebraska MEDICAID 10025388400 BCBS

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