Jackson, Danny Wade
Jackson, Danny Wade is an individual health care provider with primary practice located at 29 S Fourth St , Rolling Fork MS 39159-5146. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, Danny Wade can be contacted via phone (662) 873-4361.Contact Information
Primary practice address
29 S Fourth St
Rolling Fork MS 39159-5146
Phone: (662) 873-4361
Fax: (662) 873-2921
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 09390 | Mississippi |
Profile Details
| NPI number | 1821013095 |
|---|---|
| LBN Legal business name | Jackson, Danny Wade |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jan 21st, 2010 - about 16 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 | 1821013095 | NPPES |
| Mississippi | MEDICAID | 00019909 |
Popular Providers
-
Brehio, Teri L
15 Antrim Rd Hdfh, Hillsboro NH 03244-5204 -
Wildenberg, Hope A
105 E Sydnor Ave Ste 100 , Ridgecrest CA 93555-5546 -
Eason, Angelia Michele
283 W Race St , Rolling Fork MS 39159-2621 -
Killian, James Wendall
402 Cumberland Ave , Williamsburg KY 40769-1238 -
D'Ambrosio, Umberto
1212 S Main St , Salinas CA 93901-2260 -
Baker, Michael Leo
29 S Fourth St , Rolling Fork MS 39159-5146 -
Fluharty, Kelly C
800 Grand Central Mall Suite 4, Vienna WV 26105-4131 -
Penner, Timothy M.
609 Liberty St , Clay Center KS 67432-1564