Jackson, Bruce

Jackson, Bruce is an individual health care provider with primary practice located at 2828 1St Ave Ste 400 , Huntington WV 25702-1236. He recently has only one registered license in Nursing Service Providers / Orthopedic, which is considered as his primary health care specialty. Jackson, Bruce can be contacted via phone (304) 525-6905.

Contact Information

Primary practice address
2828 1St Ave Ste 400 Huntington WV 25702-1236
Phone: (304) 525-6905
Fax: (304) 525-4316
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Orthopedic 163WX0800X 60256 West Virginia
Nursing Service Providers / Orthopedic 163WX0800X 398466 Ohio

Profile Details

NPI number 1598133571
LBN Legal business name Jackson, Bruce
Credentials RN, FA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2015
Last updated Sep 9th, 2015 - about 9 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 1598133571 NPPES
Ohio MEDICAID 352265
Ohio MEDICAID 0010681000

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