Jackson, John S
Jackson, John S is an individual health care provider with primary practice located at 6445 Harris Pkwy Ste. 100, Fort Worth TX 76132-4138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Jackson, John S can be contacted via phone (817) 361-6900.Contact Information
Primary practice address
6445 Harris Pkwy Ste. 100
Fort Worth TX 76132-4138
Phone: (817) 361-6900
Fax: (817) 263-2918
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | E1626 | Texas |
Profile Details
| NPI number | 1437140779 |
|---|---|
| LBN Legal business name | Jackson, John S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1437140779 | NPPES |
| Other | 85Y011 | BCBS | |
| Other | 4035105 | BCBS |
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