Jackson, James W

Jackson, James W is an individual health care provider with primary practice located at 450 Georgia Ave Ste B, Statesboro GA 30458. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Jackson, James W can be contacted via phone (912) 489-4123.

Contact Information

Primary practice address
450 Georgia Ave Ste B Statesboro GA 30458
Phone: (912) 489-4123
Fax: (912) 764-4977
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 034372 Georgia

Profile Details

NPI number 1467547836
LBN Legal business name Jackson, James W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Oct 9th, 2013 - about 13 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 1467547836 NPPES
Georgia MEDICAID 000569687F
Georgia MEDICAID 000569687D
Georgia MEDICAID 000569687T
Georgia Other 366237
Georgia Other 390006768
Georgia MEDICAID 000569687Q
Georgia MEDICAID 000569687R
Georgia MEDICAID 000569687V
Georgia MEDICAID 000569687X
Georgia MEDICAID 000569687E
Georgia MEDICAID 000569687G
Georgia Other 10063368
Georgia MEDICAID 000569687H
Georgia MEDICAID 000569687S

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