Jackson, Daniel B

Jackson, Daniel B is an individual health care provider with primary practice located at 2720 Plaza Dr Suite 1100, Wausau WI 54401-4158. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jackson, Daniel B can be contacted via phone (715) 847-2472.

Contact Information

Primary practice address
2720 Plaza Dr Suite 1100 Wausau WI 54401-4158
Phone: (715) 847-2472
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1074 Wisconsin

Profile Details

NPI number 1356376230
LBN Legal business name Jackson, Daniel B
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 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 1356376230 NPPES
Wisconsin MEDICAID 42976600

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