Flandry, Jacqueline Nicole
Flandry, Jacqueline Nicole is an sole proprietor health care provider with primary practice located at 1150 Brookstone Centre Pkwy , Columbus GA 31904-4577. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Flandry, Jacqueline Nicole can be contacted via phone (706) 257-4189.Contact Information
Primary practice address
1150 Brookstone Centre Pkwy
Columbus GA 31904-4577
Phone: (706) 257-4189
Fax: (706) 257-4194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 70111 | Georgia |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 070111 | Georgia |
Profile Details
| NPI number | 1306089800 |
|---|---|
| LBN Legal business name | Flandry, Jacqueline Nicole |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 13th, 2009 |
| Last updated | Jun 17th, 2020 - about 4 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 | 1306089800 | NPPES |
| Georgia | Other | 202G708679 | MEDICARE PTAN |
| Georgia | MEDICAID | 003159653A | MEDICARE PTAN |
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