Jackson, Martha A
Jackson, Martha A is an sole proprietor health care provider with primary practice located at 2501 Crestwood Rd Suite 101, North Little Rock AR 72116-7615. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Jackson, Martha A can be contacted via phone (501) 771-4785.Contact Information
Primary practice address
2501 Crestwood Rd Suite 101
North Little Rock AR 72116-7615
Phone: (501) 771-4785
Fax: (501) 771-4787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 87 | Arkansas |
Profile Details
| NPI number | 1053372946 |
|---|---|
| LBN Legal business name | Jackson, Martha A |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2006 |
| Last updated | Jul 14th, 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 | 1053372946 | NPPES |
| Arkansas | Other | 16253000040 | QUAL CHOICE |
| Arkansas | Other | 5997156 | QUAL CHOICE |
| Arkansas | Other | 0580220001 | QUAL CHOICE |
| Arkansas | Other | 9468520001 | QUAL CHOICE |
| Arkansas | Other | 2720028 | QUAL CHOICE |
| Arkansas | Other | 56243 | QUAL CHOICE |
| Arkansas | Other | 56243 | QUAL CHOICE |
| Arkansas | Other | 56243 | QUAL CHOICE |
| Arkansas | Other | 56243 | QUAL CHOICE |
| Arkansas | MEDICAID | 110420717 | QUAL CHOICE |
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