Jackson, John Richard

Jackson, John Richard is an sole proprietor health care provider with primary practice located at 1290 Wonder World Dr Ste 1100 , San Marcos TX 78666-7969. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, John Richard can be contacted via phone (512) 393-3325.

Contact Information

Primary practice address
1290 Wonder World Dr Ste 1100 San Marcos TX 78666-7969
Phone: (512) 393-3325
Fax: (512) 393-3328
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 056102 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E8587 Texas

Profile Details

NPI number 1457350902
LBN Legal business name Jackson, John Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2005
Last updated Jan 24th, 2022 - about 3 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 1457350902 NPPES
Georgia MEDICAID 157509345A

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