Jackson, J Carvel

Jackson, J Carvel is an individual health care provider with primary practice located at 303 N Centennial Way , Mesa AZ 85201-6733. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Jackson, J Carvel can be contacted via phone (480) 649-3111.

Contact Information

Primary practice address
303 N Centennial Way Mesa AZ 85201-6733
Phone: (480) 649-3111
Fax: (480) 649-3113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 2543 Arizona
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 2543 Arizona

Profile Details

NPI number 1942262399
LBN Legal business name Jackson, J Carvel
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2006
Last updated Feb 2nd, 2023 - about 2 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 1942262399 NPPES
Arizona MEDICAID 111328

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