Jackson, David Spencer
Jackson, David Spencer is an individual health care provider with primary practice located at 11055 Little Patuxent Pkwy Suite 205, Columbia MD 21044-2896. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Jackson, David Spencer can be contacted via phone (410) 740-0789.Contact Information
Primary practice address
11055 Little Patuxent Pkwy Suite 205
Columbia MD 21044-2896
Phone: (410) 740-0789
Fax: (410) 740-7024
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | D35217 | Maryland |
Profile Details
| NPI number | 1891796900 |
|---|---|
| LBN Legal business name | Jackson, David Spencer |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Aug 22nd, 2019 - about 7 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 | 1891796900 | NPPES |
| Maryland | Other | 398140-03 | CAREFIRST MD RENDERING |
| Maryland | Other | 4238639 | CAREFIRST MD RENDERING |
| Maryland | Other | P528953 | CAREFIRST MD RENDERING |
| Maryland | Other | 0477972 | CAREFIRST MD RENDERING |
| Maryland | MEDICAID | 478471500 | CAREFIRST MD RENDERING |
| Maryland | Other | 060041579 | CAREFIRST MD RENDERING |
| Maryland | Other | 318934 | CAREFIRST MD RENDERING |
| Maryland | Other | 3509-0006 | CAREFIRST MD RENDERING |
| Maryland | Other | 018410 | CAREFIRST MD RENDERING |
| Maryland | Other | 0149212 | CAREFIRST MD RENDERING |
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