Jackson, Robert
Jackson, Robert is an individual health care provider with primary practice located at 8338 Allen Rd Ste 101, Allen Park MI 48101-1399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, Robert can be contacted via phone (313) 386-5500.Contact Information
Primary practice address
8338 Allen Rd Ste 101
Allen Park MI 48101-1399
Phone: (313) 386-5500
Fax: (313) 386-3444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4301047106 | Michigan |
Profile Details
| NPI number | 1891768057 |
|---|---|
| LBN Legal business name | Jackson, Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | May 15th, 2018 - about 8 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 | 1891768057 | NPPES |
| Michigan | MEDICAID | 4545062 | |
| Michigan | Other | 080104292 |
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