Jackson, David

Jackson, David is an individual health care provider with primary practice located at 1044 Belmont Ave , Youngstown OH 44504-1006. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Jackson, David can be contacted via phone (330) 746-7211.

Contact Information

Primary practice address
1044 Belmont Ave Youngstown OH 44504-1006
Phone: (330) 746-7211
Fax: (330) 656-5901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35059981J Ohio

Profile Details

NPI number 1033195607
LBN Legal business name Jackson, David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Jul 25th, 2019 - about 5 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 1033195607 NPPES
Ohio Other 700007026 RAILROAD MEDICARE
Ohio MEDICAID 0805230 RAILROAD MEDICARE
Ohio Other 001474708-0001 RAILROAD MEDICARE
Ohio Other P00360149 RAILROAD MEDICARE

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