Jackson, David Stevens

Jackson, David Stevens is an individual health care provider with primary practice located at 16 Danforth St , Hoosick Falls NY 12090-1226. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Jackson, David Stevens can be contacted via phone (518) 686-5002.

Contact Information

Primary practice address
16 Danforth St Hoosick Falls NY 12090-1226
Phone: (518) 686-5002
Fax: (518) 686-1848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 120359 New York

Profile Details

NPI number 1144219833
LBN Legal business name Jackson, David Stevens
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Jun 3rd, 2008 - about 18 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 1144219833 NPPES
New York MEDICAID 00359504
New York Other P00010321

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