Jackson, Angela Kathryn

Jackson, Angela Kathryn is an individual health care provider with primary practice located at 647 Lime City Rd , Rossford OH 43460-1444. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Jackson, Angela Kathryn can be contacted via phone (419) 666-0700.

Contact Information

Primary practice address
647 Lime City Rd Rossford OH 43460-1444
Phone: (419) 666-0700
Fax: (419) 666-9605
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4846 Ohio

Profile Details

NPI number 1366435471
LBN Legal business name Jackson, Angela Kathryn
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated May 20th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366435471 NPPES
Ohio Other 03158 PARAMOUNT
Ohio Other 000000185975 PARAMOUNT
Ohio Other 5850518 PARAMOUNT
Ohio MEDICAID 2051416 PARAMOUNT

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