Jackson, Paul
Jackson, Paul is an individual health care provider with primary practice located at 17800 Newburgh Rd Suite 103, Livonia MI 48152-2700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, Paul can be contacted via phone (734) 464-9540.Contact Information
Primary practice address
17800 Newburgh Rd Suite 103
Livonia MI 48152-2700
Phone: (734) 464-9540
Fax: (734) 464-0438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5101012453 | Michigan |
Profile Details
| NPI number | 1053391342 |
|---|---|
| LBN Legal business name | Jackson, Paul |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Mar 25th, 2021 - 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 | 1053391342 | NPPES |
| Michigan | MEDICAID | 3414244 |
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