Jackson, Adam W

Jackson, Adam W is an individual health care provider with primary practice located at 700 1St Ave S , Fargo ND 58103-1802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Jackson, Adam W can be contacted via phone (701) 234-4036.

Contact Information

Primary practice address
700 1St Ave S Fargo ND 58103-1802
Phone: (701) 234-4036
Fax: (701) 234-4050
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X R-7901 Iowa
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 40454 Iowa
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 12888 North Dakota

Profile Details

NPI number 1881801694
LBN Legal business name Jackson, Adam W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2007
Last updated Dec 30th, 2022 - about 2 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 1881801694 NPPES
North Dakota MEDICAID 18197

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