Jackson, John Ronald

Jackson, John Ronald is an individual health care provider with primary practice located at 20 Medical Village Dr Ste 302, Edgewood KY 41017-5402. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Jackson, John Ronald can be contacted via phone (859) 341-2510.

Contact Information

Primary practice address
20 Medical Village Dr Ste 302 Edgewood KY 41017-5402
Phone: (859) 341-2510
Fax: (859) 578-5888
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 35. 073600 Ohio
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 34447 Kentucky

Profile Details

NPI number 1114922911
LBN Legal business name Jackson, John Ronald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Apr 27th, 2023 - about 2 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1114922911 NPPES
Ohio MEDICAID 3003565
Ohio MEDICAID 7100093740

Popular Providers