Jackson, Mark F
Jackson, Mark F is an individual health care provider with primary practice located at 3930 Us 1 S , Saint Augustine FL 32086-7089. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Jackson, Mark F can be contacted via phone (352) 283-3568.Contact Information
Primary practice address
3930 Us 1 S
Saint Augustine FL 32086-7089
Phone: (352) 283-3568
Fax: (904) 217-3081
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 40009 | Kentucky |
Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | ME142795 | Florida |
Allopathic & Osteopathic Physicians / Addiction Medicine | 207LA0401X | ME142795 | Florida |
Profile Details
NPI number | 1255470209 |
---|---|
LBN Legal business name | Jackson, Mark F |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 6th, 2007 |
Last updated | Aug 17th, 2020 - 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 | 1255470209 | NPPES |
Other | 000000566553 | ANTHEM |
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