Gates, Jackson L

Gates, Jackson L is an sole proprietor health care provider with primary practice located at 1880 Lancaster Drive , Conyers GA 30013-6433. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Gates, Jackson L can be contacted via phone (678) 591-6509.

Contact Information

Primary practice address
1880 Lancaster Drive Conyers GA 30013-6433
Phone: (678) 591-6509
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 038767 Georgia
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 038767 Georgia

Profile Details

NPI number 1962418400
LBN Legal business name Gates, Jackson L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2006
Last updated Aug 10th, 2010 - 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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