Jackson, Morris B

Jackson, Morris B is an individual health care provider with primary practice located at 3920 S Dupont Sq Ste C , Louisville KY 40207-4615. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Jackson, Morris B can be contacted via phone (812) 282-3899.

Contact Information

Primary practice address
3920 S Dupont Sq Ste C Louisville KY 40207-4615
Phone: (812) 282-3899
Fax: (812) 282-4172
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 22181 Kentucky
Allopathic & Osteopathic Physicians / Urology 208800000X 01039636A Indiana

Profile Details

NPI number 1477511921
LBN Legal business name Jackson, Morris B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jan 29th, 2016 - about 8 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 1477511921 NPPES
Kentucky MEDICAID 64221815
Kentucky MEDICAID 201028460
Kentucky Other P00314088
Kentucky Other 00895267

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