Jackson, Michael Wayne

Jackson, Michael Wayne is an individual health care provider with primary practice located at 733 W Kearney St , Springfield MO 65803-1229. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Jackson, Michael Wayne can be contacted via phone (417) 831-7575.

Contact Information

Primary practice address
733 W Kearney St Springfield MO 65803-1229
Phone: (417) 831-7575
Fax: (417) 831-7632
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2004027940 Missouri

Profile Details

NPI number 1144207556
LBN Legal business name Jackson, Michael Wayne
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
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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Identifiers

StateTypeNumberIssuer
All States NPI 1144207556 NPPES
Missouri Other 208658 BLUE CROSS BLUE SHIELD
Missouri Other 9422836 BLUE CROSS BLUE SHIELD
Missouri Other 5687508 BLUE CROSS BLUE SHIELD
Missouri Other 7483792 BLUE CROSS BLUE SHIELD

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