Jackson, P Brian

Jackson, P Brian is an individual health care provider with primary practice located at 6825 Parker Farm Dr , Wilmington NC 28405-3168. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jackson, P Brian can be contacted via phone (910) 452-0554.

Contact Information

Primary practice address
6825 Parker Farm Dr Wilmington NC 28405-3168
Phone: (910) 452-0554
Fax: (910) 452-0767
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1294 North Carolina

Profile Details

NPI number 1598706855
LBN Legal business name Jackson, P Brian
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Mar 29th, 2023 - about 3 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 1598706855 NPPES
North Carolina MEDICAID 809042B
North Carolina Other 093VY
North Carolina Other P00789509

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