Jackson, William Clay

Jackson, William Clay is an individual health care provider with primary practice located at 7945 Wolf River Blvd , Germantown TN 38138-1762. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Jackson, William Clay can be contacted via phone (901) 683-0055.

Contact Information

Primary practice address
7945 Wolf River Blvd Germantown TN 38138-1762
Phone: (901) 683-0055
Fax: (901) 685-2969
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 31696 Tennessee
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X 31696 Tennessee

Profile Details

NPI number 1407858368
LBN Legal business name Jackson, William Clay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Sep 24th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407858368 NPPES
Mississippi MEDICAID 01751779
Mississippi MEDICAID 1508274
Mississippi MEDICAID 155538001

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