Jackson, John T
Jackson, John T is an individual health care provider with primary practice located at 11 Friendship St , Newport RI 02840-2271. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Jackson, John T can be contacted via phone (401) 845-1593.Contact Information
Primary practice address
11 Friendship St
Newport RI 02840-2271
Phone: (401) 845-1593
Fax: (401) 847-0650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA00132 | Rhode Island |
Profile Details
| NPI number | 1295792687 |
|---|---|
| LBN Legal business name | Jackson, John T |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 28th, 2006 |
| Last updated | Apr 10th, 2009 - about 17 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 | 1295792687 | NPPES |
| Rhode Island | MEDICAID | 7006480 |
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