Jackson, Stephanie L

Jackson, Stephanie L is an individual health care provider with primary practice located at 10900 N Scottsdale Rd Suite 603, Scottsdale AZ 85254-5216. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Jackson, Stephanie L can be contacted via phone (480) 882-7470.

Contact Information

Primary practice address
10900 N Scottsdale Rd Suite 603 Scottsdale AZ 85254-5216
Phone: (480) 882-7470
Fax: (480) 922-2472
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD23663 Oregon
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 51415 Arizona

Profile Details

NPI number 1861462509
LBN Legal business name Jackson, Stephanie L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Jul 25th, 2016 - 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 1861462509 NPPES
Oregon MEDICAID 286902
Oregon MEDICAID 120461

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