Jackson, Leroy Thomas

Jackson, Leroy Thomas is an individual health care provider with primary practice located at 3205 Churchland Blvd , Chesapeake VA 23321-5205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Jackson, Leroy Thomas can be contacted via phone (757) 484-7822.

Contact Information

Primary practice address
3205 Churchland Blvd Chesapeake VA 23321-5205
Phone: (757) 484-7822
Fax: (757) 484-7362
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 4301406300 Michigan

Profile Details

NPI number 1477633980
LBN Legal business name Jackson, Leroy Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Feb 15th, 2013 - about 13 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 1477633980 NPPES
Alabama Other BLUE CROSS 51109153
Alabama Other 1477633980 51109153

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