Jackson, Dena W
Jackson, Dena W is an individual health care provider with primary practice located at 940 Brookway Blvd , Brookhaven MS 39601-2644. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Jackson, Dena W can be contacted via phone (601) 823-5000.Contact Information
Primary practice address
940 Brookway Blvd
Brookhaven MS 39601-2644
Phone: (601) 823-5000
Fax: (601) 823-4140
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 15989 | Mississippi |
Profile Details
| NPI number | 1477663318 |
|---|---|
| LBN Legal business name | Jackson, Dena W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Nov 11th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477663318 | NPPES |
| Mississippi | MEDICAID | 00124165 | |
| Mississippi | Other | P01402452 |
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