Jackson, Michael S

Jackson, Michael S is an individual health care provider with primary practice located at 620 S Madison St Ste 304 , Enid OK 73701-7270. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Jackson, Michael S can be contacted via phone (580) 233-6350.

Contact Information

Primary practice address
620 S Madison St Ste 304 Enid OK 73701-7270
Phone: (580) 233-6350
Fax: (580) 233-6106
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 04-28958 Kansas
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 30290 Oklahoma

Profile Details

NPI number 1194755793
LBN Legal business name Jackson, Michael S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Sep 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194755793 NPPES
Kansas MEDICAID 100387680A
Kansas MEDICAID 100387680H

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