Jackson, Evan

Jackson, Evan is an individual health care provider with primary practice located at 1101 N Vandemark Rd , Sidney OH 45365-3567. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Jackson, Evan can be contacted via phone (937) 492-8080.

Contact Information

Primary practice address
1101 N Vandemark Rd Sidney OH 45365-3567
Phone: (937) 492-8080
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X C09000163 Ohio

Profile Details

NPI number 1902290497
LBN Legal business name Jackson, Evan
Credentials PC-CR
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2015
Last updated Mar 24th, 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.

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