Jackson, Dorothy Jean

Jackson, Dorothy Jean is an individual health care provider with primary practice located at 3801 Blue Pkwy , Kansas City MO 64130-2807. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Jackson, Dorothy Jean can be contacted via phone (816) 923-5800.

Contact Information

Primary practice address
3801 Blue Pkwy Kansas City MO 64130-2807
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R8B55 Missouri

Profile Details

NPI number 1023004009
LBN Legal business name Jackson, Dorothy Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Apr 19th, 2011 - about 13 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 1023004009 NPPES
Missouri MEDICAID 201760055

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