Jackson, Edwin J

Jackson, Edwin J is an individual health care provider with primary practice located at 112 Hospital Ln Ste 303 , Danville IN 46122. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Jackson, Edwin J can be contacted via phone (317) 718-4000.

Contact Information

Primary practice address
112 Hospital Ln Ste 303 Danville IN 46122
Phone: (317) 718-4000
Fax: (317) 718-4005
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 34. 010939 Ohio
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 34.010939 Ohio
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 02005444A Indiana
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 02005444A Indiana

Profile Details

NPI number 1972827335
LBN Legal business name Jackson, Edwin J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2010
Last updated May 19th, 2022 - about 3 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 1972827335 NPPES
Ohio MEDICAID 0093373

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