Jackson, Richard Evan

Jackson, Richard Evan is an sole proprietor health care provider with primary practice located at 106 Pinnacle Dr Suite 107, Johnson City TN 37615-6602. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Jackson, Richard Evan can be contacted via phone (423) 328-7332.

Contact Information

Primary practice address
106 Pinnacle Dr Suite 107 Johnson City TN 37615-6602
Phone: (423) 328-7332
Fax: (423) 207-1222
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 15545 Tennessee
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 15545 Tennessee

Profile Details

NPI number 1457359770
LBN Legal business name Jackson, Richard Evan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2005
Last updated Jul 17th, 2014 - about 11 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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