Jackson, Jeremy Don

Jackson, Jeremy Don is an individual health care provider with primary practice located at 2500 N State St Dept. Of Medicine, Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Jackson, Jeremy Don can be contacted via phone (601) 984-5601.

Contact Information

Primary practice address
2500 N State St Dept. Of Medicine Jackson MS 39216-4500
Phone: (601) 984-5601
Fax: (601) 984-6665
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X T-1892 Mississippi
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 20241 Mississippi

Profile Details

NPI number 1790996544
LBN Legal business name Jackson, Jeremy Don
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated Oct 6th, 2017 - about 7 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 1790996544 NPPES
Mississippi Other P01402453 RR MEDICARE
Mississippi MEDICAID 02585707 RR MEDICARE

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