Jackson, Larry K

Jackson, Larry K is an individual health care provider with primary practice located at 2660 10Th Ave S Suite 528, Birmingham AL 35205-1605. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Jackson, Larry K can be contacted via phone (205) 933-9258.

Contact Information

Primary practice address
2660 10Th Ave S Suite 528 Birmingham AL 35205-1605
Phone: (205) 933-9258
Fax: (205) 933-6504
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 00006718 Alabama

Profile Details

NPI number 1275574295
LBN Legal business name Jackson, Larry K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Jan 22nd, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275574295 NPPES
Alabama Other 51087222 BLUE CROSS
Alabama Other 87222 BLUE CROSS
Alabama Other 410564 BLUE CROSS

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