Jackson, James

Jackson, James is an individual health care provider with primary practice located at 236 Simpson Ave , Elkhart IN 46516-4666. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, James can be contacted via phone (574) 293-0052.

Contact Information

Primary practice address
236 Simpson Ave Elkhart IN 46516-4666
Phone: (574) 293-0052
Fax: (574) 293-3744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001724A Indiana

Profile Details

NPI number 1548251937
LBN Legal business name Jackson, James
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Aug 12th, 2016 - about 10 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 1548251937 NPPES
Indiana MEDICAID 200482280

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