Jackson-Williams, Phyllis Renee
Jackson-Williams, Phyllis Renee is an sole proprietor health care provider with primary practice located at 11312 Jefferson Hwy , River Ridge LA 70123-1709. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Jackson-Williams, Phyllis Renee can be contacted via phone (504) 463-5999.Contact Information
Primary practice address
11312 Jefferson Hwy
River Ridge LA 70123-1709
Phone: (504) 463-5999
Fax: (504) 463-5990
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5004 | Louisiana |
Profile Details
| NPI number | 1912050832 |
|---|---|
| LBN Legal business name | Jackson-Williams, Phyllis Renee |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Mar 23rd, 2012 - about 14 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 | 1912050832 | NPPES |
| Louisiana | MEDICAID | 1850047 |
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