Jackson, Bradley S

Jackson, Bradley S is an individual health care provider with primary practice located at 5386 Cox Smith Rd Suite A, Mason OH 45040-9289. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Jackson, Bradley S can be contacted via phone (513) 770-3466.

Contact Information

Primary practice address
5386 Cox Smith Rd Suite A Mason OH 45040-9289
Phone: (513) 770-3466
Fax: (513) 770-3467
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 060290 Ohio

Profile Details

NPI number 1265495329
LBN Legal business name Jackson, Bradley S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jul 8th, 2007 - about 17 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 1265495329 NPPES
Ohio MEDICAID 827681

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