Jackson, Timothy L
Jackson, Timothy L is an individual health care provider with primary practice located at 2206 Executive Dr Ste F , Hampton VA 23666-2583. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jackson, Timothy L can be contacted via phone (757) 825-1440.Contact Information
Primary practice address
2206 Executive Dr Ste F
Hampton VA 23666-2583
Phone: (757) 825-1440
Fax: (757) 825-1587
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0110002037 | Virginia |
Profile Details
| NPI number | 1982623625 |
|---|---|
| LBN Legal business name | Jackson, Timothy L |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Sep 17th, 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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