Jackson, Jimmie K
Jackson, Jimmie K is an individual health care provider with primary practice located at 1237 Glenbrook Dr , Oklahoma City OK 73118-1021. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jackson, Jimmie K can be contacted via phone (405) 659-7578.Contact Information
Primary practice address
1237 Glenbrook Dr
Oklahoma City OK 73118-1021
Phone: (405) 659-7578
Fax: (405) 232-3767
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 8567 | Oklahoma |
Profile Details
| NPI number | 1891761599 |
|---|---|
| LBN Legal business name | Jackson, Jimmie K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2006 |
| Last updated | Apr 10th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891761599 | NPPES |
| Oklahoma | MEDICAID | 100087430A |
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