Jackson, Jon Richard
Jackson, Jon Richard is an individual health care provider with primary practice located at 5000 Hennessy Blvd , Baton Rouge LA 70808-4375. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Jackson, Jon Richard can be contacted via phone (225) 765-4050.Contact Information
Primary practice address
5000 Hennessy Blvd
Baton Rouge LA 70808-4375
Phone: (225) 765-4050
Fax: (225) 765-4046
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 12488R | Louisiana |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 12488R | Louisiana |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 12488R | Louisiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 12488R | Louisiana |
Profile Details
| NPI number | 1013909118 |
|---|---|
| LBN Legal business name | Jackson, Jon Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Mar 26th, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013909118 | NPPES |
| Other | P00020219 | RAIL ROAD MEDICARE | |
| MEDICAID | 01738210 | RAIL ROAD MEDICARE | |
| MEDICAID | 1535931 | RAIL ROAD MEDICARE |
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