Jackson, Richard J
Jackson, Richard J is an individual health care provider with primary practice located at 1901 Sw H K Dodgen Loop , Temple TX 76502-3500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Jackson, Richard J can be contacted via phone (254) 935-4000.Contact Information
Primary practice address
1901 Sw H K Dodgen Loop
Temple TX 76502-3500
Phone: (254) 935-4000
Fax: (254) 935-4111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | N-8271 | Arkansas |
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | N3094 | Texas |
Profile Details
| NPI number | 1215027883 |
|---|---|
| LBN Legal business name | Jackson, Richard J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Jun 8th, 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 | 1215027883 | NPPES |
| Texas | MEDICAID | 125912907 | |
| Texas | MEDICAID | 137345810 | |
| Texas | MEDICAID | 140442852 | |
| Texas | MEDICAID | 121627001 | |
| Texas | MEDICAID | 125912908 |
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