Jackson, David K
Jackson, David K is an sole proprietor health care provider with primary practice located at 200 Henry Clay Ave , New Orleans LA 70118-5911. He recently has only one registered license in Behavioral Health & Social Service Providers / Prescribing (Medical), which is considered as his primary health care specialty. Jackson, David K can be contacted via phone (504) 896-7272.Contact Information
Primary practice address
200 Henry Clay Ave
New Orleans LA 70118-5911
Phone: (504) 896-7272
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Prescribing (Medical) | 103TP0016X | 694MP | Louisiana |
Profile Details
| NPI number | 1053464339 |
|---|---|
| LBN Legal business name | Jackson, David K |
| Credentials | PHD MSCP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 19th, 2007 |
| Last updated | May 7th, 2008 - about 16 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 | 1053464339 | NPPES |
| Louisiana | MEDICAID | 1677833 |
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