Tackett, Jim R
Tackett, Jim R is an individual health care provider with primary practice located at 1101 Veterans Dr , Lexington KY 40502-2235. 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. Tackett, Jim R can be contacted via phone (859) 233-4511.Contact Information
Primary practice address
1101 Veterans Dr
Lexington KY 40502-2235
Phone: (859) 233-4511
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA553 | Kentucky |
Profile Details
| NPI number | 1104882083 |
|---|---|
| LBN Legal business name | Tackett, Jim R |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 21st, 2006 |
| Last updated | Feb 24th, 2011 - about 15 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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