Jackson, Christopher A
Jackson, Christopher A is an individual health care provider with primary practice located at 166 4Th St E , Saint Paul MN 55101-1421. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Jackson, Christopher A can be contacted via phone (651) 292-2043.Contact Information
Primary practice address
166 4Th St E
Saint Paul MN 55101-1421
Phone: (651) 292-2043
Fax: (651) 292-2204
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 34215 | Minnesota |
Profile Details
| NPI number | 1073591012 |
|---|---|
| LBN Legal business name | Jackson, Christopher A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2006 |
| Last updated | Jun 9th, 2010 - about 14 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 | 1073591012 | NPPES |
| Minnesota | MEDICAID | 135305500 |
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