Jackson, Kevin Anthony

Jackson, Kevin Anthony is an sole proprietor health care provider with primary practice located at 2470 Constellation Dr Unit 103 , Lake Havasu City AZ 86403-4944. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Jackson, Kevin Anthony can be contacted via phone (310) 484-8432.

Contact Information

Primary practice address
2470 Constellation Dr Unit 103 Lake Havasu City AZ 86403-4944
Phone: (310) 484-8432
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X D08566611 Arizona

Profile Details

NPI number 1427829548
LBN Legal business name Jackson, Kevin Anthony
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2024
Last updated Jan 9th, 2024 - about 11 months 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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