Jackson, Kathy Jo
Jackson, Kathy Jo is an individual health care provider with primary practice located at 117 W Paterson St , Kalamazoo MI 49007-2557. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Jackson, Kathy Jo can be contacted via phone (269) 349-2641.Contact Information
Primary practice address
117 W Paterson St
Kalamazoo MI 49007-2557
Phone: (269) 349-2641
Fax: (269) 349-2898
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 070748 | Michigan |
Profile Details
| NPI number | 1306914296 |
|---|---|
| LBN Legal business name | Jackson, Kathy Jo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2006 |
| Last updated | Dec 27th, 2022 - about 4 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 | 1306914296 | NPPES |
| Michigan | MEDICAID | 104509048 |
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