Jackson, Billy Michael
Jackson, Billy Michael is an individual health care provider with primary practice located at 3917 West Rd Suite 150, Los Alamos NM 87544. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jackson, Billy Michael can be contacted via phone (505) 662-4351.Contact Information
Primary practice address
3917 West Rd Suite 150
Los Alamos NM 87544
Phone: (505) 662-4351
Fax: (505) 662-4351
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 72160 | New Mexico |
Profile Details
| NPI number | 1629076864 |
|---|---|
| LBN Legal business name | Jackson, Billy Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Apr 16th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629076864 | NPPES |
| New Mexico | MEDICAID | 18523 |
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