Jackson, Allen Thomas

Jackson, Allen Thomas is an individual health care provider with primary practice located at 1201 S Ridgewood Ave , Daytona Beach FL 32114-6123. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Jackson, Allen Thomas can be contacted via phone (386) 492-7718.

Contact Information

Primary practice address
1201 S Ridgewood Ave Daytona Beach FL 32114-6123
Phone: (386) 492-7718
Fax: (386) 492-7720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME80695 Florida

Profile Details

NPI number 1932151479
LBN Legal business name Jackson, Allen Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Mar 7th, 2023 - 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 1932151479 NPPES
Florida MEDICAID 001628800

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