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
Fax: (269) 349-2898
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306914296 NPPES
Michigan MEDICAID 104509048

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