Jackson, Dena W

Jackson, Dena W is an individual health care provider with primary practice located at 940 Brookway Blvd , Brookhaven MS 39601-2644. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Jackson, Dena W can be contacted via phone (601) 823-5000.

Contact Information

Primary practice address
940 Brookway Blvd Brookhaven MS 39601-2644
Phone: (601) 823-5000
Fax: (601) 823-4140
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 15989 Mississippi

Profile Details

NPI number 1477663318
LBN Legal business name Jackson, Dena W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Nov 11th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477663318 NPPES
Mississippi MEDICAID 00124165
Mississippi Other P01402452

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