Jackson, Gabrielle K.

Jackson, Gabrielle K. is an individual health care provider with primary practice located at 1901 Tate Springs Rd , Lynchburg VA 24501-1109. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Jackson, Gabrielle K. can be contacted via phone (434) 200-5895.

Contact Information

Primary practice address
1901 Tate Springs Rd Lynchburg VA 24501-1109
Phone: (434) 200-5895
Fax: (434) 200-7529
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 0101231613 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101231613 Virginia

Profile Details

NPI number 1487651832
LBN Legal business name Jackson, Gabrielle K.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Feb 28th, 2023 - about last year

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 1487651832 NPPES
Other 010214769 VA PREMIER PROVIDER NUMBE
Other 6122638001 VA PREMIER PROVIDER NUMBE
Other 329076 VA PREMIER PROVIDER NUMBE
Other 55500 VA PREMIER PROVIDER NUMBE
Other B5342 VA PREMIER PROVIDER NUMBE
Other 186404 VA PREMIER PROVIDER NUMBE
Other 20-3639329 VA PREMIER PROVIDER NUMBE
Other 203639329014 VA PREMIER PROVIDER NUMBE
Other P00475085 VA PREMIER PROVIDER NUMBE
MEDICAID 010214769 VA PREMIER PROVIDER NUMBE
Other 203639329 VA PREMIER PROVIDER NUMBE

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