Jackson, Daniel Mark
Jackson, Daniel Mark is an sole proprietor health care provider with primary practice located at 713 N 114Th St , Omaha NE 68154-1515. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jackson, Daniel Mark can be contacted via phone (402) 991-3131.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 960 | Nebraska |
Profile Details
| NPI number | 1972502391 |
|---|---|
| LBN Legal business name | Jackson, Daniel Mark |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 18th, 2005 |
| Last updated | Jun 1st, 2016 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972502391 | NPPES |
| Nebraska | Other | 37154 | BCBS |
| Nebraska | MEDICAID | 10025388500 | BCBS |
| Nebraska | Other | P00393695 | BCBS |
| Nebraska | Other | 904415 | BCBS |
| Nebraska | MEDICAID | 10025583800 | BCBS |
| Nebraska | MEDICAID | 10025388400 | BCBS |
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