Jackson, Allen B
Jackson, Allen B is an sole proprietor health care provider with primary practice located at 8761 Dorchester Rd Ste 100 , North Charleston SC 29420-7320. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Jackson, Allen B can be contacted via phone (843) 767-3323.Contact Information
Primary practice address
8761 Dorchester Rd Ste 100
North Charleston SC 29420-7320
Phone: (843) 767-3323
Fax: (843) 767-4252
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 13680 | South Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 13680 | South Carolina |
Profile Details
| NPI number | 1902866965 |
|---|---|
| LBN Legal business name | Jackson, Allen B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Nov 3rd, 2023 - about last year |
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 | 1902866965 | NPPES |
| South Carolina | MEDICAID | GP6738 | |
| South Carolina | MEDICAID | 136800 |
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