Jackson, David Dewitt
Jackson, David Dewitt is an individual health care provider with primary practice located at 708 S South St Ste 100, Mt Airy NC 27030-4426. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jackson, David Dewitt can be contacted via phone (336) 789-9176.Contact Information
Primary practice address
708 S South St Ste 100
Mt Airy NC 27030-4426
Phone: (336) 789-9176
Fax: (336) 786-3778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 18662 | North Carolina |
Profile Details
| NPI number | 1942206453 |
|---|---|
| LBN Legal business name | Jackson, David Dewitt |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Oct 29th, 2015 - about 9 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 | 1942206453 | NPPES |
| North Carolina | Other | 1912995093 | SURRY SURGICAL GROUP NPI |
| North Carolina | MEDICAID | 8945509 | SURRY SURGICAL GROUP NPI |
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