Jackson, Chad Edwin

Jackson, Chad Edwin is an sole proprietor health care provider with primary practice located at 14110 Six Mile Cypress Pkwy , Fort Myers FL 33912-4314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Jackson, Chad Edwin can be contacted via phone (239) 479-6411.

Contact Information

Primary practice address
14110 Six Mile Cypress Pkwy Fort Myers FL 33912-4314
Phone: (239) 479-6411
Fax: (239) 768-2032
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2083S0010X AL2986 Florida

Profile Details

NPI number 1518484245
LBN Legal business name Jackson, Chad Edwin
Credentials MS, ATC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2017
Last updated Aug 24th, 2017 - about 8 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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