Jackson, Robert

Jackson, Robert is an individual health care provider with primary practice located at 8338 Allen Rd Ste 101, Allen Park MI 48101-1399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jackson, Robert can be contacted via phone (313) 386-5500.

Contact Information

Primary practice address
8338 Allen Rd Ste 101 Allen Park MI 48101-1399
Phone: (313) 386-5500
Fax: (313) 386-3444
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301047106 Michigan

Profile Details

NPI number 1891768057
LBN Legal business name Jackson, Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated May 15th, 2018 - about 7 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 1891768057 NPPES
Michigan MEDICAID 4545062
Michigan Other 080104292

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