Jackson, Paul D
Jackson, Paul D is an sole proprietor health care provider with primary practice located at 508 Arnold Ave , Greenville MS 38701-5319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Jackson, Paul D can be contacted via phone (662) 335-4000.Contact Information
Primary practice address
508 Arnold Ave
Greenville MS 38701-5319
Phone: (662) 335-4000
Fax: (662) 332-3867
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 09542 | Mississippi |
Profile Details
| NPI number | 1053322974 |
|---|---|
| LBN Legal business name | Jackson, Paul D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Sep 26th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053322974 | NPPES |
| Other | P00386728 | RR MEDICARE | |
| MEDICAID | 00011234 | RR MEDICARE | |
| MEDICAID | 1528005 | RR MEDICARE |
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