Jackson, Jeffrey Burke
Jackson, Jeffrey Burke is an individual health care provider with primary practice located at 100 Seneca Rd , Elkins WV 26241-9709. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Jackson, Jeffrey Burke can be contacted via phone (304) 637-2777.Contact Information
Primary practice address
100 Seneca Rd
Elkins WV 26241-9709
Phone: (304) 637-2777
Fax: (304) 636-8825
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | 16375 | West Virginia |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 16375 | West Virginia |
Profile Details
| NPI number | 1780611590 |
|---|---|
| LBN Legal business name | Jackson, Jeffrey Burke |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Jan 23rd, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780611590 | NPPES |
| West Virginia | MEDICAID | 0074811000 |
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