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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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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Identifiers

StateTypeNumberIssuer
All States NPI 1780611590 NPPES
West Virginia MEDICAID 0074811000

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