Jackson, Jacob

Jackson, Jacob is an individual health care provider with primary practice located at 12266 De Paul Dr Ste 305 , Bridgeton MO 63044-2514. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jackson, Jacob can be contacted via phone (314) 770-0991.

Contact Information

Primary practice address
12266 De Paul Dr Ste 305 Bridgeton MO 63044-2514
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2015012493 Missouri

Profile Details

NPI number 1861832644
LBN Legal business name Jackson, Jacob
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2013
Last updated Nov 10th, 2020 - about 5 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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