Jackson, Kurt T
Jackson, Kurt T is an individual health care provider with primary practice located at 22 Old Short Hills Rd Ste 202 , Livingston NJ 07039-5605. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Jackson, Kurt T can be contacted via phone (201) 961-3975.Contact Information
Primary practice address
22 Old Short Hills Rd Ste 202
Livingston NJ 07039-5605
Phone: (201) 961-3975
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 25MA09011700 | New Jersey |
Profile Details
NPI number | 1619161858 |
---|---|
LBN Legal business name | Jackson, Kurt T |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 30th, 2007 |
Last updated | Feb 1st, 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 | 1619161858 | NPPES |
New Jersey | MEDICAID | 371351 |
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