Jackson, Randy

Jackson, Randy is an individual health care provider with primary practice located at 280 Pattonsville Rd , Jackson OH 45640-9452. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Jackson, Randy can be contacted via phone (740) 446-5000.

Contact Information

Primary practice address
280 Pattonsville Rd Jackson OH 45640-9452
Phone: (740) 446-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APRN.CRNA.0020099 Ohio

Profile Details

NPI number 1407470719
LBN Legal business name Jackson, Randy
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2020
Last updated Jan 21st, 2021 - 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 1407470719 NPPES
Ohio MEDICAID 0408956

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