Jackson, Kevin R

Jackson, Kevin R is an individual health care provider with primary practice located at 19752 Snowden St , Detroit MI 48235-1180. He recently has only one registered license in Other Service Providers / Health Educator, which is considered as his primary health care specialty. Jackson, Kevin R can be contacted via phone (313) 282-7040.

Contact Information

Primary practice address
19752 Snowden St Detroit MI 48235-1180
Phone: (313) 282-7040
Fax: (313) 861-4215
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Health Educator 174H00000X

Profile Details

NPI number 1366724270
LBN Legal business name Jackson, Kevin R
Credentials CERTIFICATION
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2011
Last updated Sep 16th, 2011 - about 15 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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