Jackson, Mike

Jackson, Mike is an sole proprietor health care provider with primary practice located at 6700 Ayleshire Dr , Solon OH 44139-3866. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Jackson, Mike can be contacted via phone (440) 759-2512.

Contact Information

Primary practice address
6700 Ayleshire Dr Solon OH 44139-3866
Phone: (440) 759-2512
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X

Profile Details

NPI number 1861098659
LBN Legal business name Jackson, Mike
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 8th, 2020
Last updated Dec 8th, 2020 - about 5 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 1861098659 NPPES
Ohio MEDICAID 910001002810

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