Jackson, Pamela Lee

Jackson, Pamela Lee is an individual health care provider with primary practice located at 353 Blair Park Rd , Williston VT 05495-7530. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Jackson, Pamela Lee can be contacted via phone (802) 847-1440.

Contact Information

Primary practice address
353 Blair Park Rd Williston VT 05495-7530
Phone: (802) 847-1440
Fax: (802) 847-3014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 42-0008559 Vermont

Profile Details

NPI number 1619905072
LBN Legal business name Jackson, Pamela Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Jan 8th, 2015 - about 11 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 1619905072 NPPES
Vermont MEDICAID OVN0393
Vermont MEDICAID E01148865

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