Jackson, Kenneth William

Jackson, Kenneth William is an individual health care provider with primary practice located at 12255 Fair Lakes Parkway , Fairfax VA 22033-3952. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Jackson, Kenneth William can be contacted via phone (703) 934-5905.

Contact Information

Primary practice address
12255 Fair Lakes Parkway Fairfax VA 22033-3952
Phone: (703) 934-5905
Fax: (703) 934-5778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 0101038325 Virginia

Profile Details

NPI number 1578621843
LBN Legal business name Jackson, Kenneth William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Jul 8th, 2007 - about 19 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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