Jackson, Ronnie Lee

Jackson, Ronnie Lee is an sole proprietor health care provider with primary practice located at 100 Northcrest Dr , Springfield TN 37172-3927. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Jackson, Ronnie Lee can be contacted via phone (615) 384-2411.

Contact Information

Primary practice address
100 Northcrest Dr Springfield TN 37172-3927
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MD020868 Tennessee

Profile Details

NPI number 1174500896
LBN Legal business name Jackson, Ronnie Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 22nd, 2005
Last updated Dec 14th, 2015 - about 10 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 1174500896 NPPES
Tennessee MEDICAID 3077609

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