Jackson, David B
Jackson, David B is an individual health care provider with primary practice located at 4410 Watermelon Rd , Northport AL 35473-5204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Jackson, David B can be contacted via phone (205) 345-1520.Contact Information
Primary practice address
4410 Watermelon Rd
Northport AL 35473-5204
Phone: (205) 345-1520
Fax: (205) 345-1761
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 00018093 | Alabama |
Profile Details
| NPI number | 1710928296 |
|---|---|
| LBN Legal business name | Jackson, David B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Dec 23rd, 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 | 1710928296 | NPPES |
| Alabama | Other | 051022709 | BCBS |
| Alabama | MEDICAID | 000022709 | BCBS |
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