Jackson, Mark F

Jackson, Mark F is an individual health care provider with primary practice located at 3930 Us 1 S , Saint Augustine FL 32086-7089. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Jackson, Mark F can be contacted via phone (352) 283-3568.

Contact Information

Primary practice address
3930 Us 1 S Saint Augustine FL 32086-7089
Phone: (352) 283-3568
Fax: (904) 217-3081
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 40009 Kentucky
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X ME142795 Florida
Allopathic & Osteopathic Physicians / Addiction Medicine 207LA0401X ME142795 Florida

Profile Details

NPI number 1255470209
LBN Legal business name Jackson, Mark F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2007
Last updated Aug 17th, 2020 - about 5 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 1255470209 NPPES
Other 000000566553 ANTHEM

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