Jackson, Tanjela M
Jackson, Tanjela M is an individual health care provider with primary practice located at 3620 M L King Jr Dr Sw , Atlanta GA 30331-3711. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Jackson, Tanjela M can be contacted via phone (404) 696-7300.Contact Information
Primary practice address
3620 M L King Jr Dr Sw
Atlanta GA 30331-3711
Phone: (404) 696-7300
Fax: (404) 699-3514
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 054755 | Georgia |
Profile Details
| NPI number | 1265420574 |
|---|---|
| LBN Legal business name | Jackson, Tanjela M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Dec 16th, 2020 - about 6 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 | 1265420574 | NPPES |
| Georgia | Other | 2490487 | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477F | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477H | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477 | UNITED HEALTH CARE |
| Georgia | Other | 7889745 | UNITED HEALTH CARE |
| Georgia | Other | 52152577 | UNITED HEALTH CARE |
| Georgia | Other | 7368440 | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477G | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477K | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477E | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477I | UNITED HEALTH CARE |
| Georgia | MEDICAID | 748360477J | UNITED HEALTH CARE |
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