Jackson, Don M

Jackson, Don M is an individual health care provider with primary practice located at 810 W Forest Ave , Jackson TN 38301-3942. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Jackson, Don M can be contacted via phone (731) 668-1853.

Contact Information

Primary practice address
810 W Forest Ave Jackson TN 38301-3942
Phone: (731) 668-1853
Fax: (731) 664-7731
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 37418 Tennessee

Profile Details

NPI number 1467448753
LBN Legal business name Jackson, Don M
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Feb 14th, 2012 - about 14 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 1467448753 NPPES
Tennessee MEDICAID 3607048

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