Jackson, Leron C
Jackson, Leron C is an individual health care provider with primary practice located at 590 Manning Dr , Chapel Hill NC 27599-6616. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Jackson, Leron C can be contacted via phone (919) 966-0210.Contact Information
Primary practice address
590 Manning Dr
Chapel Hill NC 27599-6616
Phone: (919) 966-0210
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2011-00809 | North Carolina |
Profile Details
| NPI number | 1316143670 |
|---|---|
| LBN Legal business name | Jackson, Leron C |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2007 |
| Last updated | Jul 30th, 2021 - about 4 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 | 1316143670 | NPPES |
| North Carolina | MEDICAID | 13190004 |
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